| Sara Ridley Counseling Practice, Llc | |
|
1315 Granger Ave Lakewood OH 44107-2232 | |
| (440) 941-3285 | |
| (440) 815-2189 |
| Full Name | Sara Ridley Counseling Practice, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1315 Granger Ave, Lakewood, Ohio |
| Authorized Official Name and Position | Sara Joyce Ridley (OWER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4402416054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sara Ridley Counseling Practice, Llc 1315 Granger Ave Lakewood OH 44107-2232 Ph: (440) 941-3285 | Sara Ridley Counseling Practice, Llc 1315 Granger Ave Lakewood OH 44107-2232 Ph: (440) 941-3285 |
| NPI Number | 1477082857 |
|---|---|
| Provider Enumeration Date | 06/08/2017 |
| Last Update Date | 08/19/2022 |
| Certification Date | 08/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477082857 | NPI | - | NPPES |
| 0099016 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | I1000364 (Ohio) | Primary |
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