Provider Demographics
NPI:1003237389
Name:SMITH, SABRINA (LCSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:ELDDINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2401 E 6TH ST STE 3037-175
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-3955
Mailing Address - Country:US
Mailing Address - Phone:512-431-8696
Mailing Address - Fax:
Practice Address - Street 1:2501 W WILLIAM CANNON DR STE 6A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-344-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA366381041C0700X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical