Provider Demographics
NPI:1134616717
Name:SPEICH, SARAH DANIELLE (MSSW, LISW-S)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DANIELLE
Last Name:SPEICH
Suffix:
Gender:F
Credentials:MSSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6855 CENTRAL COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9306
Mailing Address - Country:US
Mailing Address - Phone:740-584-4055
Mailing Address - Fax:
Practice Address - Street 1:130 NORTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-7473
Practice Address - Country:US
Practice Address - Phone:614-407-4645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1601023104100000X
OHI.1901992-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker