Provider Demographics
NPI:1417601584
Name:FORSTER, SARA (LSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FORSTER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:CRAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:708 KRESSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-6439
Mailing Address - Country:US
Mailing Address - Phone:815-276-5900
Mailing Address - Fax:
Practice Address - Street 1:330 W TERRA COTTA AVE STE 4
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3552
Practice Address - Country:US
Practice Address - Phone:815-382-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36478101YA0400X
IL150.104879101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)