Provider Demographics
NPI:1629623194
Name:LEWIS, SARA BRITTANY (LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BRITTANY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 N NIKE CT
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9429
Mailing Address - Country:US
Mailing Address - Phone:208-699-3681
Mailing Address - Fax:
Practice Address - Street 1:1044 NORTHWEST BLVD STE F
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2165
Practice Address - Country:US
Practice Address - Phone:208-676-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-38388104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker