Provider Demographics
NPI:1619516689
Name:PACE, SARAH M (CDCA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:M
Last Name:PACE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W 44TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6812
Mailing Address - Country:US
Mailing Address - Phone:440-462-8020
Mailing Address - Fax:440-538-1278
Practice Address - Street 1:1227 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6605
Practice Address - Country:US
Practice Address - Phone:330-647-6767
Practice Address - Fax:330-919-9700
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-23
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH172341101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator