Healthcare Provider Details

I. General information

NPI: 1952234569
Provider Name (Legal Business Name): SARAH A SCHALLER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH A PETERSON

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

639 YORK ST RM 212
QUINCY IL
62301-3919
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 217-222-6277
  • Fax: 217-214-5450
Mailing address:
  • Phone: 660-665-1962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number150116620
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: