Individual
MRS. BETTY LEWIS ST.CYR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003922
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272785
BLUE CROSS BLUE SHIELD
VA
01
—
309673
AMERIGROUP
VA
05
—
4945247
—
VA
Enumeration date
03/21/2007
Last updated
07/08/2007
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