Provider Demographics
NPI:1043814163
Name:WEGNER, SABRINA (LPC)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:WEGNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6003
Mailing Address - Country:US
Mailing Address - Phone:318-322-6500
Mailing Address - Fax:318-322-5118
Practice Address - Street 1:1105 HUDSON LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6003
Practice Address - Country:US
Practice Address - Phone:318-322-6500
Practice Address - Fax:318-322-5118
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1294106H00000X
LA7170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist