Provider Demographics
NPI:1184313264
Name:SARAH LENNOX, LICSW, LLC
Entity type:Organization
Organization Name:SARAH LENNOX, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LENNOX
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:339-244-0096
Mailing Address - Street 1:125 CHURCH ST UNIT 90-293
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1991
Mailing Address - Country:US
Mailing Address - Phone:339-244-0096
Mailing Address - Fax:339-244-0980
Practice Address - Street 1:125 CHURCH ST UNIT 90-293
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1991
Practice Address - Country:US
Practice Address - Phone:339-244-0096
Practice Address - Fax:339-244-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health