Provider Demographics
NPI:1417108135
Name:HEGARTY, DAVID J (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:HEGARTY
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 HIGHWATER AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-8312
Mailing Address - Country:US
Mailing Address - Phone:516-795-9415
Mailing Address - Fax:
Practice Address - Street 1:33 HIGHWATER AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-8312
Practice Address - Country:US
Practice Address - Phone:516-795-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist