Healthcare Provider Details

I. General information

NPI: 1386120632
Provider Name (Legal Business Name): SARAH ANN SEBBAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10850 S US HIGHWAY 1 STE 2
PORT ST LUCIE FL
34952-6407
US

IV. Provider business mailing address

714 EMPRESS ST SE
PALM BAY FL
32909-3737
US

V. Phone/Fax

Practice location:
  • Phone: 772-463-0444
  • Fax:
Mailing address:
  • Phone: 321-209-5149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY12764
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY12764
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: