Active NPI
Sara M Coleman, LISW
- Clinical Social Worker
- Mentor, OH
National Provider Identifier
1144325150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I0003719
- Practice address
- 7972 Tyler Blvd
Mentor, OH 44060-4806 - Phone
- (440) 974-8817
- Fax
- (440) 974-6688
- NPI assigned
- Sep 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I0003719 | OH | Primary |
Addresses
Primary practice location
7972 Tyler Blvd
Mentor, OH 44060-4806
Mailing address
7972 Tyler Blvd
Mentor, OH 44060-4806
Phone (440) 974-8817
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000115491 | Other | ANTHEM BCBS | |
| 5739052 | Other | AETNA HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I0003719 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144325150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7972 TYLER BLVD",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604806",
"telephone_number": "440-974-8817",
"fax_number": "440-974-6688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7972 TYLER BLVD",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604806",
"telephone_number": "440-974-8817",
"fax_number": "440-974-6688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "SARA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I0003719",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000115491",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH CARE",
"identifier": "5739052",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.