Healthcare Provider Details

I. General information

NPI: 1164761623
Provider Name (Legal Business Name): SABRINA ROFFMAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 S AMUNDSEN LN
AIRMONT NY
10901-7518
US

IV. Provider business mailing address

8 S AMUNDSEN LN
AIRMONT NY
10901-7518
US

V. Phone/Fax

Practice location:
  • Phone: 845-367-1660
  • Fax: 800-863-2384
Mailing address:
  • Phone: 845-367-1660
  • Fax: 800-863-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8057471
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: