Healthcare Provider Details

I. General information

NPI: 1194407346
Provider Name (Legal Business Name): SABRINA SARTORI ROCHA CHOUINARD MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 11/16/2024
Certification Date: 11/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12951 UNIVERSITY AVE STE 200E
CLIVE IA
50325-8297
US

IV. Provider business mailing address

12951 UNIVERSITY AVE STE 200E
CLIVE IA
50325-8297
US

V. Phone/Fax

Practice location:
  • Phone: 515-758-8747
  • Fax: 515-758-8747
Mailing address:
  • Phone: 515-758-8747
  • Fax: 515-758-8747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107677
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: