Healthcare Provider Details

I. General information

NPI: 1104312768
Provider Name (Legal Business Name): SARAH L HUNTINGTON LICDC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MOSELEY

II. Dates (important events)

Enumeration Date: 07/07/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9083 MENTOR AVE
MENTOR OH
44060-6462
US

IV. Provider business mailing address

9083 MENTOR AVE
MENTOR OH
44060-6462
US

V. Phone/Fax

Practice location:
  • Phone: 440-205-2667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2305279
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number162512
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: