Provider Demographics
NPI:1740602119
Name:SADER, ERIC ALLEN (JD, MSW, LSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ALLEN
Last Name:SADER
Suffix:
Gender:M
Credentials:JD, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 E. 10TH STREET, HODGE HALL
Mailing Address - Street 2:SUITE 4080
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47405
Mailing Address - Country:US
Mailing Address - Phone:812-855-4877
Mailing Address - Fax:
Practice Address - Street 1:1309 E. 10TH STREET, HODGE HALL
Practice Address - Street 2:SUITE 4080
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47405-1701
Practice Address - Country:US
Practice Address - Phone:812-855-4877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8925104100000X
IN104100000X
IN33008207A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker