Provider Demographics
NPI:1932117454
Name:SAIA LEWIS, TARA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:LYNN
Last Name:SAIA LEWIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 WESTERN PL STE 300
Mailing Address - Street 2:VA FW-MHC
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4664
Mailing Address - Country:US
Mailing Address - Phone:817-570-2230
Mailing Address - Fax:817-570-2231
Practice Address - Street 1:6000 WESTERN PL STE 300
Practice Address - Street 2:VA FW-MHC
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4664
Practice Address - Country:US
Practice Address - Phone:817-570-2230
Practice Address - Fax:817-570-2231
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32426103TC0700X, 103TH0100X, 103T00000X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy