Provider Demographics
NPI:1376013607
Name:SABRAH, NADIAH (MSW, LCSW, THERAPIST)
Entity Type:Individual
Prefix:
First Name:NADIAH
Middle Name:
Last Name:SABRAH
Suffix:
Gender:F
Credentials:MSW, LCSW, THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4933 BENCHMARK CENTRE DR STE E
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-8927
Mailing Address - Country:US
Mailing Address - Phone:314-348-5209
Mailing Address - Fax:
Practice Address - Street 1:4933 BENCHMARK CENTRE DR STE E
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-8927
Practice Address - Country:US
Practice Address - Phone:314-348-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
IL149.0231551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150.102844OtherLSW