Provider Demographics
NPI:1497953657
Name:NEWMAN, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:NEWMAN
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 1:72 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5109
Mailing Address - Country:US
Mailing Address - Phone:330-655-2674
Mailing Address - Fax:330-650-2609
Practice Address - Street 1:72 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-5109
Practice Address - Country:US
Practice Address - Phone:330-655-2674
Practice Address - Fax:330-650-2609
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI07000721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLASW34171Medicare UPIN