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NPI Code Detail

MEDICARE: AMANDA LEWIS, LPC, LLC

MEDICARE: AMANDA LEWIS, LPC, LLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366055790
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMANDA LEWIS, LPC, LLC
Provider Business Mailing Address
First Line : 7000 COOMBS FARM RD STE 202
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-0803
Country : US
Telephone Number : 304-413-5002
Fax Number :
Provider Business Practice Location Address
First Line : 1101 ABOUT TOWN PL
Second Line :
City : MORGANTOWN
State : WV
Zip : 26508-5838
Country : US
Telephone Number : 304-413-5002
Fax Number :
Authorized Official
Title or Position : OWNER/CLINICAL THERAPIST
Name : AMANDA LEWIS
Credential :
Telephone Number : 304-413-5002
Provider Enumeration Date : 08/25/2020
Last Update Date : 12/10/2025

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