MEDICARE: MS. LAFONDA M LEWIS LCPC, LPC

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	101YP2500X	Professional Counselor	PRC13762	DC
2	101YP2500X	Professional Counselor	LC1687	MD

General Provider Information

NPI Number	:	1316053119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAFONDA M LEWIS LCPC, LPC

Provider Business Mailing Address
First Line	:	2101 E JEFFERSON ST
Second Line	:	KAISER PERMANENTE MEDICARE ENROLLMENT
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 AUTH WAY
Second Line	:	KAISER MARLOW HEIGHTS MEDICAL CENTER
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	06/18/2021

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