Provider Demographics
NPI:1003493560
Name:WELCH, SARAH ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:WELCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-2232
Mailing Address - Country:US
Mailing Address - Phone:708-254-1379
Mailing Address - Fax:
Practice Address - Street 1:1802 N DIVISION ST STE 509
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-3107
Practice Address - Country:US
Practice Address - Phone:815-941-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional