Provider Demographics
NPI:1497256010
Name:KOLKMEYER, SARAH ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ANN
Last Name:KOLKMEYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:RAKAUSKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:10735 S CICERO AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-6214
Mailing Address - Country:US
Mailing Address - Phone:708-424-0001
Mailing Address - Fax:
Practice Address - Street 1:10735 S CICERO AVE STE 208
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6214
Practice Address - Country:US
Practice Address - Phone:708-424-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional