Provider Demographics
NPI:1487270161
Name:BASQUEZ, SABRINA LEE (LCSW)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:LEE
Last Name:BASQUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7102 W FRIENDLY AVE UNIT 306
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6395
Mailing Address - Country:US
Mailing Address - Phone:336-405-2601
Mailing Address - Fax:
Practice Address - Street 1:1101 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1829
Practice Address - Country:US
Practice Address - Phone:336-405-2601
Practice Address - Fax:336-421-2791
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0156791041C0700X
NCP0145561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical