Provider Demographics
NPI:1205143484
Name:SARA SCHWARZBAUM AND ASSOCIATES
Entity type:Organization
Organization Name:SARA SCHWARZBAUM AND ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARZBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCPC LMFT
Authorized Official - Phone:312-416-6191
Mailing Address - Street 1:233 E ERIE ST
Mailing Address - Street 2:SUITE 404-A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2926
Mailing Address - Country:US
Mailing Address - Phone:312-416-6191
Mailing Address - Fax:312-416-6191
Practice Address - Street 1:233 E ERIE ST
Practice Address - Street 2:SUITE 404-A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2926
Practice Address - Country:US
Practice Address - Phone:312-416-6191
Practice Address - Fax:312-416-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2012-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002414101YM0800X, 101YP2500X
IL166000827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty