Provider Demographics
NPI:1811317589
Name:DRENIK, SARAH (LSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DRENIK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6988 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-9009
Mailing Address - Country:US
Mailing Address - Phone:440-576-1736
Mailing Address - Fax:
Practice Address - Street 1:207 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:44047-1453
Practice Address - Country:US
Practice Address - Phone:440-576-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 00289561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical