Provider Demographics
NPI:1356816474
Name:MEHIGEN, SARAH (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:MEHIGEN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 CANDLEWYCK DR
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5219
Mailing Address - Country:US
Mailing Address - Phone:860-212-8971
Mailing Address - Fax:
Practice Address - Street 1:465 SILAS DEANE HWY STE 4
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-2134
Practice Address - Country:US
Practice Address - Phone:860-721-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT274103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst