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General NPI Number Information
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NPI Number | 1952561425
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Entity Type | Organization
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Legal Business Name | SARA CARPENTER WHITE, INC.
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 2027 W BRADLEY PL
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City | CHICAGO
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State | IL
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Zip | 60618-4907
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Country | US
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Telephone | 773-805-0836
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Fax | 773-883-9855
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Provider Business Mailing Address
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Address Line | 2027 W BRADLEY PL
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City | CHICAGO
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State | IL
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Zip | 60618-4907
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Country | US
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Telephone | 773-805-0836
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Fax | 773-883-9855
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. SARA CARPENTER WHITE
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Credential | LCSW
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Telephone | 773-805-0863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 149.009262
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License Number State | IL
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