Provider Demographics
NPI:1023197407
Name:SCHMITZ, SARA LISA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LISA
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 NORTH BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1169
Mailing Address - Country:US
Mailing Address - Phone:773-909-9328
Mailing Address - Fax:
Practice Address - Street 1:1024 NORTH BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1169
Practice Address - Country:US
Practice Address - Phone:773-909-9328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health