Provider Demographics
NPI:1154820967
Name:BOWIE, SARAH JANE (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:BOWIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:GLUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:911 N TRUMBULL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-4043
Mailing Address - Country:US
Mailing Address - Phone:718-938-4174
Mailing Address - Fax:
Practice Address - Street 1:911 N TRUMBULL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-4043
Practice Address - Country:US
Practice Address - Phone:718-938-4174
Practice Address - Fax:718-938-4174
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490181201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical