Individual provider Active NPI

Sabrina Khawaja, MHCLP

  • Professional Counselor
  • New York, NY
National Provider Identifier
1790305670
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9682 Issued in CA
Practice address
303 5TH Ave RM 1909
New York, NY 10016-6658
Phone
(212) 545-9901
NPI assigned
Apr 21, 2020
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P102620 NY
Professional Counselor 101YP2500X 9682 CA Primary

Addresses

Primary practice location

303 5TH Ave RM 1909
New York, NY 10016-6658

Mailing address

100 S Doheny Dr Apt 703
Los Angeles, CA 90048-2992
Phone (732) 947-2403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9682CAMDAddiction (Substance Use Disorder) Counselor
P102620NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mirielle Therapy Practice, PLLC PastSince Apr 26, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1790305670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S DOHENY DR APT 703",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900482992",
            "telephone_number": "732-947-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 5TH AVE RM 1909",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166658",
            "telephone_number": "212-545-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAWAJA",
        "first_name": "SABRINA",
        "credential": "MHCLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P102620",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "9682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.