MEDICARE: SARAH LASHAY RHENA FERGUSON

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCDCIII.162384	OH
2	171M00000X	Case Manager/Care Coordinator		OH
3	104100000X	Social Worker	S.2613941	OH

General Provider Information

NPI Number	:	1285391730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LASHAY RHENA FERGUSON

Provider Business Mailing Address
First Line	:	817 ORLANDO AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-1812
Country	:	US
Telephone Number	:	330-322-2529
Fax Number	:

Provider Business Practice Location Address
First Line	:	3094 W MARKET ST STE 343
Second Line	:
City	:	FAIRLAWN
State	:	OH
Zip	:	44333-3618
Country	:	US
Telephone Number	:	234-334-5589
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	05/30/2026

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