Provider Demographics
NPI:1770087645
Name:STAGLES, SARA NADINE (LSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:NADINE
Last Name:STAGLES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:NADINE
Other - Last Name:HELMINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:145 WESTWOODS
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001
Mailing Address - Country:US
Mailing Address - Phone:440-653-1081
Mailing Address - Fax:440-277-0549
Practice Address - Street 1:2115 W PARK DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053
Practice Address - Country:US
Practice Address - Phone:440-989-4900
Practice Address - Fax:440-277-0549
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1701423104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker