Provider Demographics
NPI:1396413944
Name:MEICHTRY, SABRINA (APSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:MEICHTRY
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6314
Mailing Address - Country:US
Mailing Address - Phone:608-368-8087
Mailing Address - Fax:
Practice Address - Street 1:540 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6314
Practice Address - Country:US
Practice Address - Phone:608-368-8087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127203-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical