Healthcare Provider Details

I. General information

NPI: 1558600700
Provider Name (Legal Business Name): SARA LAUER TIGAY LCPC, LMFT, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 11/13/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 N COMMONWEALTH AVE 6TH FLOOR
CHICAGO IL
60657-6211
US

IV. Provider business mailing address

1415 N CAMPBELL AVE APT 2
CHICAGO IL
60622-1753
US

V. Phone/Fax

Practice location:
  • Phone: 847-493-3532
  • Fax: 847-493-3531
Mailing address:
  • Phone: 740-225-4559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401018543
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number32127
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.009296
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166000882
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: