Provider Demographics
NPI:1215422415
Name:ALLEN, SABRINA A (CAC-IN PROCESS)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CAC-IN PROCESS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29901-1228
Mailing Address - Country:US
Mailing Address - Phone:843-255-6000
Mailing Address - Fax:
Practice Address - Street 1:1905 DUKE ST STE 270
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-4403
Practice Address - Country:US
Practice Address - Phone:843-255-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)