Provider Demographics
NPI:1952561425
Name:SARA CARPENTER WHITE, INC.
Entity Type:Organization
Organization Name:SARA CARPENTER WHITE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:CARPENTER
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-805-0863
Mailing Address - Street 1:2027 W BRADLEY PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4907
Mailing Address - Country:US
Mailing Address - Phone:773-805-0836
Mailing Address - Fax:773-883-9855
Practice Address - Street 1:2027 W BRADLEY PL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4907
Practice Address - Country:US
Practice Address - Phone:773-805-0836
Practice Address - Fax:773-883-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.009262251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health