Provider Demographics
NPI:1588706436
Name:ALTHOLZ, SABINA LYNNE (CLSW)
Entity type:Individual
Prefix:MS
First Name:SABINA
Middle Name:LYNNE
Last Name:ALTHOLZ
Suffix:
Gender:F
Credentials:CLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 PEARL ST.
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L7R2N4
Mailing Address - Country:CA
Mailing Address - Phone:905-681-3550
Mailing Address - Fax:
Practice Address - Street 1:145 E 15TH ST APT 2U
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3533
Practice Address - Country:US
Practice Address - Phone:905-681-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0124401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical