Provider Demographics
NPI:1366017212
Name:SARGENT, CALEB C (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:C
Last Name:SARGENT
Suffix:
Gender:M
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 TALL GRASS CIR APT 310
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6945
Mailing Address - Country:US
Mailing Address - Phone:740-525-0813
Mailing Address - Fax:
Practice Address - Street 1:1179 TALL GRASS CIR APT 310
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6945
Practice Address - Country:US
Practice Address - Phone:740-525-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.20051831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical