Individual ProviderSally L. StrukSocial WorkerBehavioral Health & Social Service ProvidersPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819(216) 932-2800PECOS EnrollmentBased on the most recent information from CMS, provider Sally L. Struk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1093018962Provider TypeIndividualFull NameStruk, Sally L.TitleMs.CredentialLISW-S, CDCAGenderFemaleSole ProprietorYesEnumeration Date12/14/2010Last Updated3/7/2016Contact InformationPractice LocationPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819Phone(216) 932-2800FaxUnlisted FaxMailing LocationMailing Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseI.0031667-SUPVOhioCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense150606Ohio