Provider Demographics
NPI:1184040446
Name:PHOU, SARA E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:E
Last Name:PHOU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:E
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:451 N LASALLE STREET
Mailing Address - Street 2:FLOOR 4
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4510
Mailing Address - Country:US
Mailing Address - Phone:312-893-7239
Mailing Address - Fax:312-755-0928
Practice Address - Street 1:451 N LASALLE STREET
Practice Address - Street 2:FLOOR 4
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4510
Practice Address - Country:US
Practice Address - Phone:312-893-7239
Practice Address - Fax:312-755-0928
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0164621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical