Provider Demographics
NPI:1124572979
Name:SAWYER, LAKEYSHA MARQUITA (LCSWA)
Entity type:Individual
Prefix:
First Name:LAKEYSHA
Middle Name:MARQUITA
Last Name:SAWYER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 WINDING CANYON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-5013
Mailing Address - Country:US
Mailing Address - Phone:704-258-3224
Mailing Address - Fax:
Practice Address - Street 1:635 COX RD
Practice Address - Street 2:SUITE B
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3424
Practice Address - Country:US
Practice Address - Phone:704-691-7561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0108901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical