Provider Demographics
NPI:1245870492
Name:CHANNELL, SARA M (MAED, LPCC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:M
Last Name:CHANNELL
Suffix:
Gender:F
Credentials:MAED, LPCC
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:M
Other - Last Name:BABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 WINDHAM CT STE 2
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5035
Mailing Address - Country:US
Mailing Address - Phone:330-726-2888
Mailing Address - Fax:330-726-2888
Practice Address - Street 1:955 WINDHAM CT STE 2
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5035
Practice Address - Country:US
Practice Address - Phone:330-726-2888
Practice Address - Fax:330-726-2888
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303645101YP2500X
OHC.1801345-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0386971Medicaid