Provider Demographics
NPI:1922319201
Name:BEN-SHAHAR, SARAH CLARKE (LCSW, LMSW, JD)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:CLARKE
Last Name:BEN-SHAHAR
Suffix:
Gender:F
Credentials:LCSW, LMSW, JD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, LMSW, JD
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE 831
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:773-753-0404
Mailing Address - Fax:
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE 831
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:773-753-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0131311041C0700X
MI68010849361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical