Provider Demographics
NPI:1225534043
Name:JASTRAM, SABRINA RENEE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:RENEE
Last Name:JASTRAM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 POSTAL RD STE 3B
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2318
Mailing Address - Country:US
Mailing Address - Phone:410-643-9290
Mailing Address - Fax:410-643-9293
Practice Address - Street 1:1563 POSTAL RD STE 3B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2318
Practice Address - Country:US
Practice Address - Phone:410-643-9290
Practice Address - Fax:410-643-9293
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical