Healthcare Provider Details

I. General information

NPI: 1811807712
Provider Name (Legal Business Name): DORINA ANTONIA SABIO PALACIOS CASAC-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 ELM PL FL 2
BROOKLYN NY
11201-5355
US

IV. Provider business mailing address

25 ELM PL FL 2
BROOKLYN NY
11201-5355
US

V. Phone/Fax

Practice location:
  • Phone: 718-802-0666
  • Fax: 718-858-9493
Mailing address:
  • Phone: 718-802-0666
  • Fax: 718-858-9493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number36473
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: