Provider Demographics
NPI:1134138928
Name:MAURICE, SABRA RACHELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:SABRA
Middle Name:RACHELLE
Last Name:MAURICE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 TOUCAN WAY UNIT 103
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-5285
Mailing Address - Country:US
Mailing Address - Phone:309-696-0993
Mailing Address - Fax:
Practice Address - Street 1:106 GRANT RD
Practice Address - Street 2:
Practice Address - City:MARQUETTE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:61554-1227
Practice Address - Country:US
Practice Address - Phone:309-696-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional