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NPI Code Detail

MEDICARE: SARA R MACK CT

MEDICARE: SARA R MACK CT
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
1101Y00000XCounselorC.2507228-TRNEOH
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1164929949
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA R MACK CT
Provider Business Mailing Address
First Line : 2000 NOBLE DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-5353
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9029
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 03/12/2026

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Directions to “ SARA R MACK CT” Practice Location

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