Provider Demographics
NPI:1619373339
Name:LEE, SARAH A (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N CROSS POINTE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9163
Mailing Address - Country:US
Mailing Address - Phone:812-401-1836
Mailing Address - Fax:812-401-1813
Practice Address - Street 1:728 N CROSS POINTE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-9163
Practice Address - Country:US
Practice Address - Phone:812-401-1836
Practice Address - Fax:812-401-1813
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical