1689622987 NPI number — MS. ANNE L. SABO LMFTQ

Table of content: MS. ANNE L. SABO LMFTQ (NPI 1689622987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689622987 NPI number — MS. ANNE L. SABO LMFTQ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABO
Provider First Name:
ANNE
Provider Middle Name:
L.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMFTQ
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWER
Provider Other First Name:
ANNE
Provider Other Middle Name:
L.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689622987
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 PEPPERWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28311-9331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-644-3905
Provider Business Mailing Address Fax Number:
910-222-3195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 S MCPHERSON CHURCH RD
Provider Second Line Business Practice Location Address:
SUITE 231
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28303-4974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-485-0041
Provider Business Practice Location Address Fax Number:
910-222-3195
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  1363 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6105328 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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