Healthcare Provider Details

I. General information

NPI: 1114852985
Provider Name (Legal Business Name): SANDRA MCCAULEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 NILES CORTLAND RD NE STE B-C
WARREN OH
44484-1974
US

IV. Provider business mailing address

321 NILES CORTLAND RD NE STE B-C
WARREN OH
44484-1974
US

V. Phone/Fax

Practice location:
  • Phone: 330-355-3234
  • Fax: 330-975-6343
Mailing address:
  • Phone: 330-355-3234
  • Fax: 330-975-6343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: