Provider Demographics
NPI:1992837967
Name:SAX, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:SAX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 S KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2208
Mailing Address - Country:US
Mailing Address - Phone:708-354-9850
Mailing Address - Fax:708-361-5740
Practice Address - Street 1:521 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6700
Practice Address - Country:US
Practice Address - Phone:708-354-9850
Practice Address - Fax:708-361-5740
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical