Provider Demographics
NPI:1518481860
Name:SACKETT, ROBERT (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SACKETT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 N SHEFFIELD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5003
Mailing Address - Country:US
Mailing Address - Phone:773-281-8130
Mailing Address - Fax:
Practice Address - Street 1:2801 N SHEFFIELD AVE FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5003
Practice Address - Country:US
Practice Address - Phone:773-281-8130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012799101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty