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General NPI Number Information
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NPI Number | 1821520206
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Entity Type | Organization
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Legal Business Name | SABRINA GASKILL LICENSED CLINICAL WORKER LC LLC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 706 S 1ST ST
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City | TUCUMCARI
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State | NM
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Zip | 88401-2715
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Country | US
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Telephone | 575-461-8783
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Fax | 575-461-9624
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Provider Business Mailing Address
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Address Line | 518 E CENTER ST
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City | TUCUMCARI
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State | NM
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Zip | 88401-2270
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Country | US
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Telephone | 575-461-7909
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MS. SABRINA GASKILL
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Credential | LCSW
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Telephone | 575-461-7909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-09783
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License Number State | NM
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