MEDICARE: SARA LYNN GARL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180009842	IL
2	101YP2500X	Professional Counselor	180009842	IL

General Provider Information

NPI Number	:	1700242666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA LYNN GARL

Provider Business Mailing Address
First Line	:	2404 SPRING BROOK AVE
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-1554
Country	:	US
Telephone Number	:	815-222-1960
Fax Number	:

Provider Business Practice Location Address
First Line	:	4615 E STATE ST STE 202
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2158
Country	:	US
Telephone Number	:	847-868-3435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2016
Last Update Date	:	01/25/2025

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Directions to “ SARA LYNN GARL ” Practice Location

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