Provider Demographics
NPI:1699221788
Name:STANLEY, SARA (LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:LOMONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8301 CYPRESS PLAZA DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4420
Mailing Address - Country:US
Mailing Address - Phone:904-733-9818
Mailing Address - Fax:904-733-8864
Practice Address - Street 1:8301 CYPRESS PLAZA DR
Practice Address - Street 2:SUITE 119
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4420
Practice Address - Country:US
Practice Address - Phone:904-733-9818
Practice Address - Fax:904-733-8864
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 107581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical