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NPI Code Detail

MEDICARE: SABRINA VANCE LCSW

MEDICARE: SABRINA VANCE LCSW
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
11041C0700XClinical Social WorkerC7135MS

General Provider Information

NPI Number : 1780983742
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABRINA VANCE LCSW
Provider Business Mailing Address
First Line : 4961 BROOKWOOD PL
Second Line :
City : BYRAM
State : MS
Zip : 39272-6700
Country : US
Telephone Number : 601-454-2705
Fax Number :
Provider Business Practice Location Address
First Line : 460 BRIARWOOD DR STE 400-71
Second Line :
City : JACKSON
State : MS
Zip : 39206-3051
Country : US
Telephone Number : 601-454-2705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 03/30/2021

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Directions to “ SABRINA VANCE LCSW” Practice Location

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