Healthcare Provider Details

I. General information

NPI: 1235985417
Provider Name (Legal Business Name): SABRINA ANNE HEGGAN MA, LAC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N MAIN ST STE B3
WILLIAMSTOWN NJ
08094-1475
US

IV. Provider business mailing address

PO BOX 93
RICHWOOD NJ
08074-0093
US

V. Phone/Fax

Practice location:
  • Phone: 856-777-3178
  • Fax:
Mailing address:
  • Phone: 609-634-7708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00750500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: