Provider Demographics
NPI:1164172490
Name:WASHINGTON, SABRINA (DHA)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:DHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19624 GOVERNORS HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2077
Mailing Address - Country:US
Mailing Address - Phone:312-434-4640
Mailing Address - Fax:
Practice Address - Street 1:19624 GOVERNORS HWY STE 101
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2077
Practice Address - Country:US
Practice Address - Phone:312-434-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178018301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health