Provider Demographics
NPI:1679927412
Name:WHITE, SARA MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:WHITE
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 1:545 HINMAN AVE APT K1
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3053
Mailing Address - Country:US
Mailing Address - Phone:224-204-4101
Mailing Address - Fax:224-714-0971
Practice Address - Street 1:545 HINMAN AVE APT K1
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3053
Practice Address - Country:US
Practice Address - Phone:224-204-4101
Practice Address - Fax:224-714-0971
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical