Healthcare Provider Details

I. General information

NPI: 1093604951
Provider Name (Legal Business Name): LAUREN HEGG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

879 NE MAIN ST STE A
SIMPSONVILLE SC
29681-2056
US

IV. Provider business mailing address

31 OPEN RANGE LN
SIMPSONVILLE SC
29681-3254
US

V. Phone/Fax

Practice location:
  • Phone: 864-688-9416
  • Fax:
Mailing address:
  • Phone: 864-365-5588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number80723
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: