Provider Demographics
NPI:1346745478
Name:FOCKEN, SARAH E (LSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:FOCKEN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:VEDDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:130 WESTROCK FARM DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45322-8731
Mailing Address - Country:US
Mailing Address - Phone:531-229-3990
Mailing Address - Fax:
Practice Address - Street 1:12 W WENGER RD # 7
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2754
Practice Address - Country:US
Practice Address - Phone:531-229-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1801960104100000X
OHI.21031231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker