Provider Demographics
NPI:1346885324
Name:NASTA, SABRINA (LMHC, MA)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:
Last Name:NASTA
Suffix:
Gender:F
Credentials:LMHC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12452 BLACKWATER CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-4057
Mailing Address - Country:US
Mailing Address - Phone:904-735-7385
Mailing Address - Fax:
Practice Address - Street 1:1406 KINGSLEY AVE STE A2
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4528
Practice Address - Country:US
Practice Address - Phone:904-735-7385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16074101Y00000X
FLMH18755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor