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General NPI Number Information
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NPI Number | 1518440056
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Entity Type | Individual
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Provider Name | SARA R GREATHOUSE MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 711 BELMONT AVE STE 2
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-1039
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Country | US
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Telephone | 330-793-2487
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Fax | 330-743-5748
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Provider Business Mailing Address
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Address Line | 4403 VILLAGE OAK LN
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City | PACE
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State | FL
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Zip | 32571-2784
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Country | US
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Telephone | 330-774-4632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW23295
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License Number State | FL
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