Provider Demographics
NPI:1023566270
Name:TREMBATH, SARA ANN (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ANN
Last Name:TREMBATH
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 E MAIN ST APT 12B
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3263
Mailing Address - Country:US
Mailing Address - Phone:330-281-7786
Mailing Address - Fax:
Practice Address - Street 1:8351 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5749
Practice Address - Country:US
Practice Address - Phone:216-839-2273
Practice Address - Fax:216-896-0735
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2001948101YP2500X, 101YM0800X
OHC 1600469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional