Healthcare Provider Details

I. General information

NPI: 1205934577
Provider Name (Legal Business Name): SANDRA KABEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SPRINGDALE RD SUITE #150
CHERRY HILL NJ
08003-2763
US

IV. Provider business mailing address

702 BIRCHFIELD DR
MOUNT LAUREL NJ
08054-4020
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-1333
  • Fax: 856-424-7384
Mailing address:
  • Phone: 856-778-7775
  • Fax: 856-778-7710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC052098
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: