Provider Demographics
NPI:1639373525
Name:GRAY-SANDERS, SABRINA KAI (LMSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:KAI
Last Name:GRAY-SANDERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21693
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-0693
Mailing Address - Country:US
Mailing Address - Phone:313-585-2853
Mailing Address - Fax:
Practice Address - Street 1:220 MANISTIQUE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215
Practice Address - Country:US
Practice Address - Phone:313-903-0639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010850001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical