Provider Demographics
NPI:1235722075
Name:HOLMES, SABRINA (MA, CASAC)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MA, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 CHILI AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-2638
Mailing Address - Country:US
Mailing Address - Phone:585-363-0852
Mailing Address - Fax:
Practice Address - Street 1:144 CHILI AVE APT 1
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2638
Practice Address - Country:US
Practice Address - Phone:585-363-0852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)