Provider Demographics
NPI:1255022091
Name:NADIAH LLC
Entity type:Organization
Organization Name:NADIAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NADIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SABRAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-799-7986
Mailing Address - Street 1:4933 BENCHMARK CENTRE DR STE E
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-8927
Mailing Address - Country:US
Mailing Address - Phone:618-799-7986
Mailing Address - Fax:
Practice Address - Street 1:4933 BENCHMARK CENTRE DR STE E
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-8927
Practice Address - Country:US
Practice Address - Phone:314-348-5209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty