Provider Demographics
NPI:1881127322
Name:OBAS, SANDRA SEYMOUR (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SEYMOUR
Last Name:OBAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 NE 191ST ST STE 500
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2832
Mailing Address - Country:US
Mailing Address - Phone:305-725-2548
Mailing Address - Fax:
Practice Address - Street 1:2875 NE 191ST ST STE 500
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2832
Practice Address - Country:US
Practice Address - Phone:305-725-2548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW200371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical