Provider Demographics
NPI:1619516689
Name:PACE, SARAH M (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:PACE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 44TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6812
Mailing Address - Country:US
Mailing Address - Phone:440-462-8020
Mailing Address - Fax:440-538-1278
Practice Address - Street 1:620 W 44TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6812
Practice Address - Country:US
Practice Address - Phone:440-462-8020
Practice Address - Fax:440-538-1278
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172341101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)