=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114664752
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH PLESZ CT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2022
-----------------------------------------------------
Last Update Date | 05/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 S MAIN ST
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44301-1664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-644-4095
-----------------------------------------------------
Fax | 234-260-2710
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3445 S MAIN ST
-----------------------------------------------------
City | COVENTRY TWP
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44319-3028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-644-4095
-----------------------------------------------------
Fax | 234-260-2710
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C2103334TRNE
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------