Provider Demographics
NPI:1508345752
Name:MCLEAN, SABRINA JOYCE
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:JOYCE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 N BRIGHTLEAF BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-7259
Mailing Address - Country:US
Mailing Address - Phone:919-934-1312
Mailing Address - Fax:919-934-1080
Practice Address - Street 1:1319 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-7259
Practice Address - Country:US
Practice Address - Phone:919-934-1312
Practice Address - Fax:919-934-1080
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0129831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1124323688Medicaid