MEDICARE: SABANOSH PSYCHIATRY & WELLNESS

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1619831203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SABANOSH PSYCHIATRY & WELLNESS

Provider Business Mailing Address
First Line	:	8401 MAYLAND DR STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 MAYLAND DR STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:	540-753-1382
Fax Number	:

Authorized Official
Title or Position	:	DIRECT OF OPERATIONS
Name	:	GREGORY ENZLER
Credential	:
Telephone Number	:	540-753-1382

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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