Healthcare Provider Details

I. General information

NPI: 1881480275
Provider Name (Legal Business Name): SABRINA ANTIONETTE WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5443 ARMOUR RD APT 701
COLUMBUS GA
31909-4587
US

IV. Provider business mailing address

5443 ARMOUR RD APT 701
COLUMBUS GA
31909-4587
US

V. Phone/Fax

Practice location:
  • Phone: 678-492-3243
  • Fax:
Mailing address:
  • Phone: 678-492-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number733234
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015657
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: