Provider Demographics
NPI:1790011971
Name:ABELL, BRIAN MARK (MSW)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MARK
Last Name:ABELL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2653 FREEPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-2458
Mailing Address - Country:US
Mailing Address - Phone:916-832-7831
Mailing Address - Fax:
Practice Address - Street 1:2653 FREEPORT BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95818-2458
Practice Address - Country:US
Practice Address - Phone:916-832-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical