Provider Demographics
NPI:1417194440
Name:SLOANE, SEPTEMBER (LISW)
Entity Type:Individual
Prefix:
First Name:SEPTEMBER
Middle Name:
Last Name:SLOANE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CURRIE HALL PKWY
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4312
Mailing Address - Country:US
Mailing Address - Phone:330-673-5812
Mailing Address - Fax:330-673-7162
Practice Address - Street 1:340 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1529
Practice Address - Country:US
Practice Address - Phone:330-253-3100
Practice Address - Fax:330-253-5248
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0700329-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker