Healthcare Provider Details

I. General information

NPI: 1043138456
Provider Name (Legal Business Name): SARA MCCANNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WHITESVILLE RD STE A
TOMS RIVER NJ
08753-4105
US

IV. Provider business mailing address

167 EDGEWOOD DR BLDG 13
TOMS RIVER NJ
08755-7350
US

V. Phone/Fax

Practice location:
  • Phone: 732-504-3527
  • Fax:
Mailing address:
  • Phone: 732-504-3527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: