Provider Demographics
NPI:1639689110
Name:CALLAWAY, SARAH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:RYKWALDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7100 GRAPHICS WAY STE 3100
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-1123
Mailing Address - Country:US
Mailing Address - Phone:740-428-0428
Mailing Address - Fax:740-909-4077
Practice Address - Street 1:7100 GRAPHICS WAY STE 3100
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-1123
Practice Address - Country:US
Practice Address - Phone:740-428-0428
Practice Address - Fax:740-909-4077
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHC.1801076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty