Provider Demographics
NPI:1356503734
Name:SAGER, WAYNE RICHARD (LPC MA)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:RICHARD
Last Name:SAGER
Suffix:
Gender:M
Credentials:LPC MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MILFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759
Mailing Address - Country:US
Mailing Address - Phone:908-591-9255
Mailing Address - Fax:
Practice Address - Street 1:109 MILFORD AVE
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2013
Practice Address - Country:US
Practice Address - Phone:908-591-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00242900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional