Kenneth Travis Sabourin, LCSW, LCDC | |
1400 Ridge Creek Ln, Bulverde, TX 78163-2804 | |
(219) 592-1156 | |
Not Available |
Full Name | Kenneth Travis Sabourin |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1400 Ridge Creek Ln, Bulverde, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770088221 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 107777 (Texas) | Primary |
Entity Name | Progressive Behavioral Health, Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659567238 PECOS PAC ID: 4486794906 Enrollment ID: O20091214000763 |
Entity Name | Sondermind Provider Network Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210326001541 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Travis Sabourin, LCSW, LCDC 24345 Wilderness Oak Apt 5208, San Antonio, TX 78258-7890 Ph: (210) 540-6821 | Kenneth Travis Sabourin, LCSW, LCDC 1400 Ridge Creek Ln, Bulverde, TX 78163-2804 Ph: (219) 592-1156 |
Mr. Joseph William Kopacsi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6575 Western Way, Bulverde, TX 78163 Phone: 830-438-7709 | |
Cherstie Anne Watson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 31316 Bridlegate Dr, Bulverde, TX 78163 Phone: 210-313-5337 |