Provider Demographics
NPI:1265103279
Name:MICHEALS, SABRINA MONIQUE
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:MONIQUE
Last Name:MICHEALS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 3RD AVE SE APT 103
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-1951
Mailing Address - Country:US
Mailing Address - Phone:425-275-6450
Mailing Address - Fax:
Practice Address - Street 1:8830 3RD AVE SE APT 103
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-1951
Practice Address - Country:US
Practice Address - Phone:425-275-6450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
61192345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health