Provider Demographics
NPI:1932989290
Name:MITCHELL, SARAH MARIE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 LAKEHURST DR APT 108
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-8251
Mailing Address - Country:US
Mailing Address - Phone:262-497-4311
Mailing Address - Fax:
Practice Address - Street 1:671 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-6101
Practice Address - Country:US
Practice Address - Phone:262-497-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker