MEDICARE: SARAH G. IANNONE LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	I1634	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004582757	OTHER	OH	AETNA
2	000000387121	OTHER	OH	ANTHEM BLUE CROSS & BLUE
3	70507	OTHER	OH	QUAL CHOICE

General Provider Information

NPI Number	:	1316098890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH G. IANNONE LISW

Provider Business Mailing Address
First Line	:	PO BOX 24102
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-0102
Country	:	US
Telephone Number	:	440-460-4574
Fax Number	:	216-378-9591

Provider Business Practice Location Address
First Line	:	1074 CANYON VIEW RD
Second Line	:
City	:	SAGAMORE HILLS
State	:	OH
Zip	:	44067-2274
Country	:	US
Telephone Number	:	440-272-4617
Fax Number	:	216-371-5425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2007
Last Update Date	:	03/11/2025

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