Basic Information
Provider Information
NPI: 1053089078
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHRIBER
FirstName: SARAH
MiddleName: SPENCER
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 530 S MAIN ST
Address2:  
City: LIMA
State: OH
PostalCode: 458041500
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2515 N MAIN ST
Address2:  
City: FINDLAY
State: OH
PostalCode: 458403972
CountryCode: US
TelephoneNumber: 4194223711
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/03/2021
LastUpdateDate: 03/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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