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General NPI Number Information
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NPI Number | 1063596583
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Entity Type | Individual
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Provider Name | SARA D. LEWIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 440 CAJON ST
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City | REDLANDS
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State | CA
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Zip | 92373-5955
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Country | US
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Telephone | 909-307-5777
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Fax | 909-307-5776
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Provider Business Mailing Address
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Address Line | 440 CAJON ST
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City | REDLANDS
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State | CA
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Zip | 92373-5955
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Country | US
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Telephone | 909-307-5777
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Fax | 909-307-5776
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW35066
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LCS29806
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS29806
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 64605
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License Number State | TX
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