Provider Demographics
NPI:1679261275
Name:GAMBE, SARAH DAVIS (MA, LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:DAVIS
Last Name:GAMBE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELLEN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17834 W CHIPPEWA RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1907
Mailing Address - Country:US
Mailing Address - Phone:662-386-4620
Mailing Address - Fax:
Practice Address - Street 1:17834 W CHIPPEWA RD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1907
Practice Address - Country:US
Practice Address - Phone:662-386-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2577101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional