Provider Demographics
NPI:1407054919
Name:BRANDT, SARA (PHD,, MS, LMFT)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:PHD,, MS, LMFT
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MS, LMFT
Mailing Address - Street 1:1255 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 1911
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3286
Mailing Address - Country:US
Mailing Address - Phone:630-290-3384
Mailing Address - Fax:224-512-9525
Practice Address - Street 1:1255 S MICHIGAN AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3286
Practice Address - Country:US
Practice Address - Phone:630-290-3384
Practice Address - Fax:224-512-9525
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166-000532106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist