Provider Demographics
NPI:1043831670
Name:CASPER, SARAH L (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:CASPER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:PENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:N8204 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53083-5101
Mailing Address - Country:US
Mailing Address - Phone:920-445-3325
Mailing Address - Fax:
Practice Address - Street 1:N8204 LAKESHORE RD
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53083-5101
Practice Address - Country:US
Practice Address - Phone:920-445-3325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIL067104Medicaid