Provider Demographics
NPI:1730719915
Name:MCINTOSH, SARAH NANCY
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:NANCY
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2748 HAMPSHIRE RD APT 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2531
Mailing Address - Country:US
Mailing Address - Phone:216-973-1780
Mailing Address - Fax:
Practice Address - Street 1:2100 LAKESIDE AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1126
Practice Address - Country:US
Practice Address - Phone:216-566-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical