Provider Demographics
NPI:1528746823
Name:LEWIS-STANKUS, SARA JANE (EDD, LPC, NBCC, NBC)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:JANE
Last Name:LEWIS-STANKUS
Suffix:
Gender:F
Credentials:EDD, LPC, NBCC, NBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492 BRYAN FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-1648
Mailing Address - Country:US
Mailing Address - Phone:304-704-0169
Mailing Address - Fax:
Practice Address - Street 1:492 BRYAN FOSTER RD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-1648
Practice Address - Country:US
Practice Address - Phone:304-704-0169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1315101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor