Healthcare Provider Details

I. General information

NPI: 1528984937
Provider Name (Legal Business Name): SARAH LEWIS LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 LOOKOUT AVE APT 504
HACKENSACK NJ
07601-3632
US

IV. Provider business mailing address

356 VAN EMBURGH AVE
RIDGEWOOD NJ
07450-2219
US

V. Phone/Fax

Practice location:
  • Phone: 201-962-0770
  • Fax:
Mailing address:
  • Phone: 201-290-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00421100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: