Provider Demographics
NPI:1720304025
Name:GURA, SARAH A (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:A
Last Name:GURA
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 BURR RIDGE PKWY
Mailing Address - Street 2:SECOND FLOOR, SUITE 253
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6423
Mailing Address - Country:US
Mailing Address - Phone:815-557-1267
Mailing Address - Fax:
Practice Address - Street 1:1333 BURR RIDGE PKWY
Practice Address - Street 2:SECOND FLOOR, SUITE 253
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6423
Practice Address - Country:US
Practice Address - Phone:815-557-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL27-2320963Medicaid