Provider Demographics
NPI:1962712588
Name:BROWN-ENGRAM, SABRINA L (MA,LMHC, EDM)
Entity type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:L
Last Name:BROWN-ENGRAM
Suffix:
Gender:F
Credentials:MA,LMHC, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1236
Mailing Address - Country:US
Mailing Address - Phone:315-794-6917
Mailing Address - Fax:315-792-9578
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1236
Practice Address - Country:US
Practice Address - Phone:315-794-6917
Practice Address - Fax:315-792-9578
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003514-1101YM0800X
NY977227101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool