Basic Information
| Provider Information | |||||||||
| NPI: | 1770215667 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SABADO | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | PUGAL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSW, JD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18901 HILLCREST ST | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481523339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346587467 | ||||||||
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| Practice Location | |||||||||
| Address1: | 707 W MILWAUKEE ST | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3133449099 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2022 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 055534 | NY | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 6851088604 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.