Provider Demographics
NPI:1750637823
Name:SABBATH, BRIDGET ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANN
Last Name:SABBATH
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 1:2700 BALD CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-1310
Mailing Address - Country:US
Mailing Address - Phone:770-530-7422
Mailing Address - Fax:
Practice Address - Street 1:9876 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3990
Practice Address - Country:US
Practice Address - Phone:770-530-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005741104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker