Provider Demographics
NPI:1326863770
Name:NITSCHKE, SARAH A (LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:NITSCHKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 MARY KAY LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1137
Mailing Address - Country:US
Mailing Address - Phone:218-831-5589
Mailing Address - Fax:
Practice Address - Street 1:910 SKOKIE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4033
Practice Address - Country:US
Practice Address - Phone:847-480-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health