Provider Demographics
NPI:1285695981
Name:LEWIS, SARAH P (LCSW)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8618
Mailing Address - Country:US
Mailing Address - Phone:434-218-3499
Mailing Address - Fax:434-202-1006
Practice Address - Street 1:675 PETER JEFFERSON PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8618
Practice Address - Country:US
Practice Address - Phone:434-218-3499
Practice Address - Fax:434-202-1006
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040042671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008925542Medicaid