Healthcare Provider Details

I. General information

NPI: 1194640110
Provider Name (Legal Business Name): SARAH MIA BARNUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 MORRIS AVE
UNION NJ
07083-7169
US

IV. Provider business mailing address

143 BROOKWOOD ST
EAST ORANGE NJ
07018-2317
US

V. Phone/Fax

Practice location:
  • Phone: 908-224-1510
  • Fax:
Mailing address:
  • Phone: 973-732-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00942400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: