Provider Demographics
NPI:1609340868
Name:FINGERLAKES LCSW COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:FINGERLAKES LCSW COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:315-209-8818
Mailing Address - Street 1:33 WILLIAM ST STE 7
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3730
Mailing Address - Country:US
Mailing Address - Phone:315-209-8818
Mailing Address - Fax:
Practice Address - Street 1:33 WILLIAM ST STE 7
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3730
Practice Address - Country:US
Practice Address - Phone:315-209-8818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty