Provider Demographics
NPI:1295723781
Name:SABATINO, BRYON ROSS (MC, LISAC, LPC)
Entity type:Individual
Prefix:MR
First Name:BRYON
Middle Name:ROSS
Last Name:SABATINO
Suffix:
Gender:M
Credentials:MC, LISAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 S COUNTRY CLUB WAY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4053
Mailing Address - Country:US
Mailing Address - Phone:480-755-4016
Mailing Address - Fax:480-755-4018
Practice Address - Street 1:3231 S COUNTRY CLUB WAY
Practice Address - Street 2:SUITE 111
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4053
Practice Address - Country:US
Practice Address - Phone:480-755-4016
Practice Address - Fax:480-755-4018
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC1620101YA0400X
AZLPC0146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health