Provider Demographics
NPI:1154771525
Name:KENNEY, SARAH JANE (LISW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:KENNEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9052 STONEGATE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-8951
Mailing Address - Country:US
Mailing Address - Phone:740-294-8125
Mailing Address - Fax:
Practice Address - Street 1:21245 LORAIN RD STE 150
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2196
Practice Address - Country:US
Practice Address - Phone:740-294-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16002471041C0700X
OHI.1600247-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical