Provider Demographics
NPI:1548705825
Name:OLENIK, SARAH J (LSW, MSW, LICDC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:OLENIK
Suffix:
Gender:F
Credentials:LSW, MSW, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:OH
Mailing Address - Zip Code:44254-1216
Mailing Address - Country:US
Mailing Address - Phone:330-636-1741
Mailing Address - Fax:330-636-1741
Practice Address - Street 1:402 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:OH
Practice Address - Zip Code:44254-1216
Practice Address - Country:US
Practice Address - Phone:330-636-1741
Practice Address - Fax:330-636-1741
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161369101YA0400X
OH1600457104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker