Provider Demographics
NPI:1588943344
Name:HYLAND, SABRINA MARIA (LPC)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:MARIA
Last Name:HYLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SABRINA
Other - Middle Name:MARIA
Other - Last Name:MCNAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 465873
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30042-5873
Mailing Address - Country:US
Mailing Address - Phone:678-835-8144
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD
Practice Address - Street 2:SUITE 635
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8701
Practice Address - Country:US
Practice Address - Phone:678-835-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA12444560OtherCAQH
GA003126146AMedicaid