Basic Information
Provider Information
NPI: 1538790829
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAWYER-BROWN
FirstName: LINDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 64 LISBON ST STE 2
Address2:  
City: LEWISTON
State: ME
PostalCode: 042408064
CountryCode: US
TelephoneNumber: 2078711211
FaxNumber: 2077822636
Practice Location
Address1: 64 LISBON ST STE 2
Address2:  
City: LEWISTON
State: ME
PostalCode: 042408064
CountryCode: US
TelephoneNumber: 2078711211
FaxNumber: 2077822636
Other Information
ProviderEnumerationDate: 01/27/2020
LastUpdateDate: 01/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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