Provider Demographics
NPI:1285030122
Name:RICHARD, SARAH (LISW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RICHARD
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 1:300 N CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2518
Mailing Address - Country:US
Mailing Address - Phone:586-610-2136
Mailing Address - Fax:
Practice Address - Street 1:470 CENTER ST
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1098
Practice Address - Country:US
Practice Address - Phone:440-279-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.14401791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical