Healthcare Provider Details

I. General information

NPI: 1215892633
Provider Name (Legal Business Name): SABRINA M BANKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BARDSTOWN CT APT 202
FAYETTEVILLE NC
28304-0489
US

IV. Provider business mailing address

418 PERSON ST
FAYETTEVILLE NC
28301-5886
US

V. Phone/Fax

Practice location:
  • Phone: 910-273-0935
  • Fax:
Mailing address:
  • Phone: 910-489-0958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0048
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: