Provider Demographics
NPI:1811067614
Name:LANMAN, SARAH ANN (PCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:LANMAN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 MARMION LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1924
Mailing Address - Country:US
Mailing Address - Phone:513-703-0371
Mailing Address - Fax:
Practice Address - Street 1:3345 WHITFIELD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2083
Practice Address - Country:US
Practice Address - Phone:513-665-4444
Practice Address - Fax:513-665-4476
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY184607OtherMEDICARE GROUP NUMBER
KY610661458OtherFEDERAL TAX ID NUMBER