Provider Demographics
NPI:1891208112
Name:SPRAGUE, SARAH BETH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BETH
Last Name:SPRAGUE
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 1:4342 GALLIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5562
Mailing Address - Country:US
Mailing Address - Phone:740-529-1184
Mailing Address - Fax:740-529-4118
Practice Address - Street 1:4342 GALLIA ST
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:OH
Practice Address - Zip Code:45662
Practice Address - Country:US
Practice Address - Phone:740-529-1184
Practice Address - Fax:740-529-4118
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1891208112OtherCOUNSELING