Provider Demographics
NPI:1881216364
Name:MACKESY MILLER, SARAH (LSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MACKESY MILLER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:MACKESY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 N SUMMIT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1884
Mailing Address - Country:US
Mailing Address - Phone:419-693-9600
Mailing Address - Fax:
Practice Address - Street 1:830 N SUMMIT ST STE 2
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1884
Practice Address - Country:US
Practice Address - Phone:419-693-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1903658104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker