Healthcare Provider Details

I. General information

NPI: 1124741749
Provider Name (Legal Business Name): SARAH RUTH BOESGER MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24600 DETROIT RD STE 265
WESTLAKE OH
44145-2542
US

IV. Provider business mailing address

5130 E 31ST ST. FLOOR 4
TULSA OK
74135
US

V. Phone/Fax

Practice location:
  • Phone: 440-742-1661
  • Fax: 949-437-2034
Mailing address:
  • Phone: 918-587-9471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2106693
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22368
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: