Healthcare Provider Details

I. General information

NPI: 1306499611
Provider Name (Legal Business Name): SARA INNAB LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA ASAD

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 W OKLAHOMA AVE STE 200
MILWAUKEE WI
53219-4303
US

IV. Provider business mailing address

5757 W OKLAHOMA AVE STE 200
MILWAUKEE WI
53219-4303
US

V. Phone/Fax

Practice location:
  • Phone: 414-431-6400
  • Fax:
Mailing address:
  • Phone: 414-431-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128188
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: