Provider Demographics
NPI:1336988872
Name:WYCKOFF, SARI ANN (LPC)
Entity type:Individual
Prefix:
First Name:SARI
Middle Name:ANN
Last Name:WYCKOFF
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 11TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2412
Mailing Address - Country:US
Mailing Address - Phone:732-720-4075
Mailing Address - Fax:
Practice Address - Street 1:1913 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1029
Practice Address - Country:US
Practice Address - Phone:732-966-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01024400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional