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NPI Code Detail

MEDICARE: SARA KOLODZIEJSKI

MEDICARE: SARA KOLODZIEJSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA173470OH
2175T00000XPeer Specialist
3104100000XSocial WorkerS2208053OH

General Provider Information

NPI Number : 1043716798
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA KOLODZIEJSKI
Provider Business Mailing Address
First Line : 452 W MARKET ST
Second Line :
City : XENIA
State : OH
Zip : 45385-2815
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2960 W ENON RD
Second Line :
City : XENIA
State : OH
Zip : 45385-8548
Country : US
Telephone Number : 937-971-2679
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2018
Last Update Date : 04/18/2025

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Directions to “ SARA KOLODZIEJSKI ” Practice Location

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