Healthcare Provider Details

I. General information

NPI: 1780407098
Provider Name (Legal Business Name): STEPHANIE R LEWIS-SMALE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE R LEWIS

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 E PECOS RD STE 307
GILBERT AZ
85295-3203
US

IV. Provider business mailing address

PO BOX 9031
CHANDLER HEIGHTS AZ
85127-9031
US

V. Phone/Fax

Practice location:
  • Phone: 480-993-2754
  • Fax: 833-962-6157
Mailing address:
  • Phone: 480-331-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-23796
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: