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General NPI Number Information
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NPI Number | 1871123638
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Entity Type | Individual
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Provider Name | RESHETA SADE EGGLESTON MSW,LSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 12/28/2025
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Provider Practice Location Address
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Address Line | 3129 DRAPER AVE SE
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City | WARREN
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State | OH
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Zip | 44484-3322
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Country | US
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Telephone | 330-942-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 2833 RED FOX RUN DR NW
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City | WARREN
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State | OH
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Zip | 44485-1573
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Country | US
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Telephone | 216-417-9703
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1500565
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | S.1500564
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License Number State | OH
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