Provider Demographics
NPI:1316746324
Name:HEADRICK, SABRINA (M ED, LPC)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:HEADRICK
Suffix:
Gender:
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ALTO
Mailing Address - State:GA
Mailing Address - Zip Code:30510-3108
Mailing Address - Country:US
Mailing Address - Phone:907-201-2162
Mailing Address - Fax:
Practice Address - Street 1:204 WESTBROOK DR
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:GA
Practice Address - Zip Code:30510-3108
Practice Address - Country:US
Practice Address - Phone:907-201-2162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015485101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor