Provider Demographics
NPI:1316098890
Name:IANNONE, SARAH G (LISW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:G
Last Name:IANNONE
Suffix:
Gender:
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:PO BOX 24102
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-0102
Mailing Address - Country:US
Mailing Address - Phone:440-460-4574
Mailing Address - Fax:216-378-9591
Practice Address - Street 1:1074 CANYON VIEW RD
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-2274
Practice Address - Country:US
Practice Address - Phone:440-272-4617
Practice Address - Fax:216-371-5425
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1634104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0004582757OtherAETNA
OH000000387121OtherANTHEM BLUE CROSS & BLUE
OH70507OtherQUAL CHOICE
OHIASW06911Medicare ID - Type Unspecified