Healthcare Provider Details

I. General information

NPI: 1104830389
Provider Name (Legal Business Name): SARAH A KEHL MSW/LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N KINGSHIGHWAY
EAST SAINT LOUIS IL
62203-1085
US

IV. Provider business mailing address

950 N KINGSHIGHWAY
EAST SAINT LOUIS IL
62203-1085
US

V. Phone/Fax

Practice location:
  • Phone: 618-394-2200
  • Fax:
Mailing address:
  • Phone: 618-394-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149012170
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: