Provider Demographics
NPI:1033559265
Name:BAJAKIAN, SABRINA HUSAIN (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:HUSAIN
Last Name:BAJAKIAN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:JENNIFER
Other - Last Name:HUSAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 W. MENDENHALL
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4708
Mailing Address - Country:US
Mailing Address - Phone:406-599-6248
Mailing Address - Fax:
Practice Address - Street 1:416 W. MENDENHALL
Practice Address - Street 2:SUITE A
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4708
Practice Address - Country:US
Practice Address - Phone:406-599-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4554-LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1033559265Medicaid