Provider Demographics
NPI:1104979814
Name:SANABRIA, SAMUEL (PHD, LMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:SANABRIA
Suffix:
Gender:M
Credentials:PHD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 NIGHTHAWK TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6349
Mailing Address - Country:US
Mailing Address - Phone:941-739-9881
Mailing Address - Fax:
Practice Address - Street 1:2155 MAIN ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6023
Practice Address - Country:US
Practice Address - Phone:941-365-2962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8959101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health