MEDICARE: KATHLYNE LEWIS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	374700000X	Technician
2	106S00000X	Behavior Technician	NV
3	103K00000X	Behavior Analyst	NV
4	175T00000X	Peer Specialist	NV
5	101Y00000X	Counselor	NV

General Provider Information

NPI Number	:	1952004632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLYNE LEWIS

Provider Business Mailing Address
First Line	:	5900 MARTITA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2478
Country	:	US
Telephone Number	:	702-544-6826
Fax Number	:

Provider Business Practice Location Address
First Line	:	5900 MARTITA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2478
Country	:	US
Telephone Number	:	702-544-6826
Fax Number	:

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

Provider Enumeration Date	:	03/23/2023
Last Update Date	:	03/22/2026

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Directions to “ KATHLYNE LEWIS ” Practice Location

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