Individual provider Active NPI

Sarah R Georgianna, PSYD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1932764552
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.011050 Issued in IL
Practice address
1438 W Belmont Ave Ste 1
Chicago, IL 60657-2166
Phone
(312) 508-3645
Fax
(312) 971-8554
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.011050 IL Primary

Addresses

Primary practice location

1438 W Belmont Ave Ste 1
Chicago, IL 60657-2166

Mailing address

1438 W Belmont Ave Ste 1
Chicago, IL 60657-2166
Phone (312) 508-3645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.011050ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Light on Anxiety, P.C. Psychologist CurrentSince May 1, 2023 Accepting new patients

Locations

1438 W Belmont Ave
Ste 1
Chicago, IL 60657
Phone 3125083645 ext. 36

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1932764552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 W BELMONT AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572166",
            "telephone_number": "312-508-3645",
            "fax_number": "312-971-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 W BELMONT AVE STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572166",
            "telephone_number": "312-508-3645",
            "fax_number": "312-971-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIANNA",
        "first_name": "SARAH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.011050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.