Healthcare Provider Details

I. General information

NPI: 1679452932
Provider Name (Legal Business Name): LEWIS FAMILY WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 E CAMELBACK RD STE 444
SCOTTSDALE AZ
85251-1257
US

IV. Provider business mailing address

3181 BERWICK KNL STE 15
BROOKLYN PARK MN
55443-1960
US

V. Phone/Fax

Practice location:
  • Phone: 763-691-9002
  • Fax: 763-226-2390
Mailing address:
  • Phone: 763-843-5403
  • Fax: 763-843-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CERISE DIONE LEWIS
Title or Position: OWNER
Credential:
Phone: 763-691-9002