Provider Demographics
NPI:1932297801
Name:SAHBA, PAUL J (LCMHC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:SAHBA
Suffix:
Gender:M
Credentials:LCMHC
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 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-223-7544
Mailing Address - Fax:802-223-6626
Practice Address - Street 1:157 BARRE ST
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3668
Practice Address - Country:US
Practice Address - Phone:802-223-7544
Practice Address - Fax:802-223-6626
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT202095OtherTRICARE
VT00019339OtherBC/BS VT
VT1046073OtherCIGNA
VT1007324Medicaid