Provider Demographics
NPI:1417711581
Name:BEDNARCIK, SARA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:BEDNARCIK
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 1:19622 GLENNELL AVE
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1210
Mailing Address - Country:US
Mailing Address - Phone:708-250-7816
Mailing Address - Fax:
Practice Address - Street 1:19622 GLENNELL AVE
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-1210
Practice Address - Country:US
Practice Address - Phone:708-250-7816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490214171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical