Provider Demographics
NPI:1437813169
Name:HAGENBUCH, SARAH VAUGHAN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:VAUGHAN
Last Name:HAGENBUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 STONEWALL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-1947
Mailing Address - Country:US
Mailing Address - Phone:970-531-4641
Mailing Address - Fax:
Practice Address - Street 1:20 STONERIDGE DR STE 202
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-6579
Practice Address - Country:US
Practice Address - Phone:970-531-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013220101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor