Provider Demographics
NPI:1710404645
Name:NORDMAN, SARAH ASHLEY (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ASHLEY
Last Name:NORDMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11525 GLENN CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-5796
Mailing Address - Country:US
Mailing Address - Phone:630-759-6615
Mailing Address - Fax:
Practice Address - Street 1:13242 S ROUTE 59 UNIT 205
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5443
Practice Address - Country:US
Practice Address - Phone:630-759-6615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL170161633OtherNPPES