Provider Demographics
NPI:1871646117
Name:STUKAS, SARAH (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STUKAS
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S VINE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4084
Mailing Address - Country:US
Mailing Address - Phone:630-563-0044
Mailing Address - Fax:630-914-6054
Practice Address - Street 1:115 S VINE ST STE 1
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4084
Practice Address - Country:US
Practice Address - Phone:630-563-0044
Practice Address - Fax:630-914-6054
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional