1649800764 NPI number — SABRINA MARIA ULRICH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649800764 NPI number — SABRINA MARIA ULRICH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SABRINA MARIA ULRICH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SABRINA ULRICH COUNSELING, LLC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649800764
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
238 W MAIN ST STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56258-1398
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-476-0495
Provider Business Mailing Address Fax Number:
507-401-3695

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
238 W MAIN ST STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56258-1398
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-476-0495
Provider Business Practice Location Address Fax Number:
507-401-3695
Provider Enumeration Date:
01/16/2020

Additional Information

Authorized Official

Authorized Official Last Name:
ULRICH
Authorized Official First Name:
SABRINA
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
507-476-0495

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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