Healthcare Provider Details

I. General information

NPI: 1306135322
Provider Name (Legal Business Name): SARAH MOCCO M.S., LCPC, CADC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2011
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MAIN ST
BUFFALO GROVE IL
60089-2717
US

IV. Provider business mailing address

1237 BERKSHIRE LN
GRAYSLAKE IL
60030-4204
US

V. Phone/Fax

Practice location:
  • Phone: 847-634-6422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number30950
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178008920
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180010897
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: