Healthcare Provider Details

I. General information

NPI: 1528746823
Provider Name (Legal Business Name): SARA JANE LEWIS-STANKUS ED.D, LPC, NBCC, NBC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

492 BRYAN FOSTER RD
BUCKHANNON WV
26201-1648
US

IV. Provider business mailing address

492 BRYAN FOSTER RD
BUCKHANNON WV
26201-1648
US

V. Phone/Fax

Practice location:
  • Phone: 304-704-0169
  • Fax:
Mailing address:
  • Phone: 304-704-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1315
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: