Provider Demographics
NPI:1609020650
Name:SABOE, SIRKKA MORIARTY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SIRKKA
Middle Name:MORIARTY
Last Name:SABOE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 SMALL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8405
Mailing Address - Country:US
Mailing Address - Phone:252-330-7971
Mailing Address - Fax:
Practice Address - Street 1:927 SMALL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8405
Practice Address - Country:US
Practice Address - Phone:252-330-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100445230Medicaid