Provider Demographics
NPI:1659928497
Name:HEGSTROM, VERNA M (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:VERNA
Middle Name:M
Last Name:HEGSTROM
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3111
Mailing Address - Country:US
Mailing Address - Phone:908-200-9118
Mailing Address - Fax:
Practice Address - Street 1:23 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3111
Practice Address - Country:US
Practice Address - Phone:908-200-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00324000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional