Provider Demographics
NPI:1003277492
Name:SALEH, SABINA MOHIN (LCSW)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:MOHIN
Last Name:SALEH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 64TH STREET
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:19195
Mailing Address - Country:US
Mailing Address - Phone:718-630-1310
Mailing Address - Fax:
Practice Address - Street 1:420 64TH STREET
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:19195
Practice Address - Country:US
Practice Address - Phone:718-630-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086690104100000X
NY0849771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker