Provider Demographics
NPI:1619382520
Name:LITZ, SARAH (LCPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LITZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:VANDERWERF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:425 HUEHL RD BLDG 19B
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2323
Mailing Address - Country:US
Mailing Address - Phone:773-459-5296
Mailing Address - Fax:
Practice Address - Street 1:425 HUEHL RD BLDG 19B
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:773-459-5296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-30
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009178101YP2500X
IL180.009178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180009178OtherLICENSE