Provider Demographics
NPI:1174640296
Name:WHITE, SARA CARPENTER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:CARPENTER
Last Name:WHITE
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 1:2027 W BRADLEY PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4907
Mailing Address - Country:US
Mailing Address - Phone:773-805-0863
Mailing Address - Fax:773-883-9855
Practice Address - Street 1:2027 W BRADLEY PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4907
Practice Address - Country:US
Practice Address - Phone:773-805-0863
Practice Address - Fax:773-883-9855
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical