Provider Demographics
NPI:1174012462
Name:SEKERAK, CARLY
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SEKERAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 STATION ST STE 300J
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4963
Mailing Address - Country:US
Mailing Address - Phone:404-299-8159
Mailing Address - Fax:
Practice Address - Street 1:8500 STATION ST STE 300J
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4963
Practice Address - Country:US
Practice Address - Phone:404-299-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator