MEDICARE: SARAH ESTLACK LSW

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	1041C0700X	Clinical Social Worker	S.2512510	OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1376324046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ESTLACK LSW

Provider Business Mailing Address
First Line	:	5000 E MARKET ST STE 30
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2259
Country	:	US
Telephone Number	:	330-856-9699
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 E MARKET ST STE 30
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2259
Country	:	US
Telephone Number	:	330-856-9699
Fax Number	:

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

Provider Enumeration Date	:	10/10/2023
Last Update Date	:	03/02/2026

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Directions to “ SARAH ESTLACK LSW” Practice Location

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