Provider Demographics
NPI:1144376161
Name:STANEFF, SARAH TERWOORD (LCP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:TERWOORD
Last Name:STANEFF
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 PARK DR
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1414
Mailing Address - Country:US
Mailing Address - Phone:440-967-0599
Mailing Address - Fax:
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:SUITE #610
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:440-356-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2357103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000116475OtherANTHEM BLUE CROSS
OH270321000OtherMAGELLAN BEHAVIORAL HEALT
OHP3220496OtherOXFORD HEALTH PLANS