Provider Demographics
NPI:1093220865
Name:DAVIS, SARAH ELIZABETH ARDEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELIZABETH ARDEN
Last Name:DAVIS
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 1:2357 HASSELL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2172
Mailing Address - Country:US
Mailing Address - Phone:847-863-2620
Mailing Address - Fax:
Practice Address - Street 1:2357 HASSELL RD STE 202
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2172
Practice Address - Country:US
Practice Address - Phone:847-466-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-02
Last Update Date:2017-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.019876101YM0800X, 103TP2701X, 261QM0855X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health