Provider Demographics
NPI:1669463188
Name:SABIN, KEITH BRANDT (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:BRANDT
Last Name:SABIN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 W 46TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-3539
Mailing Address - Country:US
Mailing Address - Phone:212-582-8051
Mailing Address - Fax:212-582-8051
Practice Address - Street 1:417 W 46TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-3539
Practice Address - Country:US
Practice Address - Phone:212-582-8051
Practice Address - Fax:212-582-8051
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047226-1101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health