Provider Demographics
NPI:1083771356
Name:SABOM, WILLIAM STEPHEN (STD, LPC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:SABOM
Suffix:
Gender:M
Credentials:STD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 SANDEN FERRY DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3343
Mailing Address - Country:US
Mailing Address - Phone:770-417-2752
Mailing Address - Fax:770-446-5643
Practice Address - Street 1:209 SWANTON WAY STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3274
Practice Address - Country:US
Practice Address - Phone:404-422-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 002055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1477605707OtherPASTORAL INSTITUTE, INC.