Provider Demographics
NPI:1679702054
Name:BENNARDO, SABRINA (LCSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:BENNARDO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:BRAISIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:233 S FEDERAL HWY
Mailing Address - Street 2:UP01
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4937
Mailing Address - Country:US
Mailing Address - Phone:561-807-3112
Mailing Address - Fax:
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:STE, 165
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:561-807-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL94321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical