Sara Phou LCSW LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SARA PHOU LCSW LLC

Practice address

5215 N Ravenswood Ave
Chicago, IL 60640-1668

Phone

(773) 340-0472

NPI assigned

Jun 4, 2024

Last updated

Jun 20, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sara Phou, LCSWNPI 1184040446

Title

Licensed Clinical Social Worker

Phone

(773) 993-2113

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sara E Phou, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1184040446
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1053152900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 W BERWYN AVE APT 1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257228",
            "telephone_number": "773-993-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401668",
            "telephone_number": "773-340-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA PHOU LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "PHOU",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "773-993-2113",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.