MEDICARE: DANA LEWIN COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1063013928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANA LEWIN COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	2710 COBBLESTONE DR
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051-2683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 N CARROLL AVE STE 140
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6454
Country	:	US
Telephone Number	:	817-797-7968
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANA MORAN LEWIN
Credential	:	LMFT
Telephone Number	:	817-797-7968

Provider Enumeration Date	:	11/05/2020
Last Update Date	:	11/05/2020

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