Provider Demographics
NPI:1942355771
Name:GOSMIRE, SABRINA R (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:R
Last Name:GOSMIRE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 JORIE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4446
Mailing Address - Country:US
Mailing Address - Phone:630-710-5729
Mailing Address - Fax:
Practice Address - Street 1:1010 JORIE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4446
Practice Address - Country:US
Practice Address - Phone:630-710-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005477101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health