Provider Demographics
NPI:1114379724
Name:WASSERMAN, SARA L (BS, MA, LPC, ATR)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:BS, MA, LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14843 W SPRAGUE RD
Mailing Address - Street 2:#A
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6601
Mailing Address - Country:US
Mailing Address - Phone:440-234-9955
Mailing Address - Fax:
Practice Address - Street 1:14843 W SPRAGUE RD
Practice Address - Street 2:#A
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6601
Practice Address - Country:US
Practice Address - Phone:440-234-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0004496101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health