Healthcare Provider Details

I. General information

NPI: 1841184645
Provider Name (Legal Business Name): SANDRA CEGELSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4771 BROADVIEW RD
CLEVELAND OH
44109-4669
US

IV. Provider business mailing address

101 PEMBROKE CT
GREENSBURG PA
15601-6404
US

V. Phone/Fax

Practice location:
  • Phone: 216-415-7959
  • Fax: 724-972-4627
Mailing address:
  • Phone: 216-415-7959
  • Fax: 724-972-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2512569
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: