Healthcare Provider Details

I. General information

NPI: 1447497276
Provider Name (Legal Business Name): SABRINA SMITH-HARGROVES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 E 176TH ST
BRONX NY
10457-6003
US

IV. Provider business mailing address

PO BOX 448
HURLEYVILLE NY
12747-0448
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-6888
  • Fax: 718-901-6880
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076209
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: