Healthcare Provider Details

I. General information

NPI: 1942135462
Provider Name (Legal Business Name): SARA HASTINGS CRC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17255 OAK PARK AVE
TINLEY PARK IL
60477-3401
US

IV. Provider business mailing address

17255 OAK PARK AVE
TINLEY PARK IL
60477-3401
US

V. Phone/Fax

Practice location:
  • Phone: 708-633-4533
  • Fax:
Mailing address:
  • Phone: 708-633-4533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1649487521
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: