MEDICARE: SABRA HAND LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	7426	SC

General Provider Information

NPI Number	:	1578174199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRA HAND LPC

Provider Business Mailing Address
First Line	:	362 MATUSKOVIC DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8213
Country	:	US
Telephone Number	:	843-830-3263
Fax Number	:

Provider Business Practice Location Address
First Line	:	1761 SOUTHWICK DR
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8428
Country	:	US
Telephone Number	:	843-619-7989
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	08/17/2020

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Directions to “ SABRA HAND LPC” Practice Location

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