Healthcare Provider Details

I. General information

NPI: 1043169493
Provider Name (Legal Business Name): SARAH SEYFANG CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 E MAIN ST
CHILLICOTHEE OH
45601-3414
US

IV. Provider business mailing address

242 E MAIN ST
CHILLICOTHEE OH
45601-3414
US

V. Phone/Fax

Practice location:
  • Phone: 740-637-9712
  • Fax: 740-773-3279
Mailing address:
  • Phone: 740-637-9712
  • Fax: 740-773-3279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.194823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: