Provider Demographics
NPI:1063678043
Name:SEDLAK, JEFFREY MICHAEL (MSW, LISW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:SEDLAK
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 PROSPECT AVE E
Mailing Address - Street 2:200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2335
Mailing Address - Country:US
Mailing Address - Phone:216-698-2615
Mailing Address - Fax:216-698-2640
Practice Address - Street 1:1849 PROSPECT AVE E
Practice Address - Street 2:200
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2335
Practice Address - Country:US
Practice Address - Phone:216-698-2615
Practice Address - Fax:216-698-2640
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI07004281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical