Healthcare Provider Details

I. General information

NPI: 1245110543
Provider Name (Legal Business Name): LISA RENEE LEWIS M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12015 E 46TH AVE STE 300
DENVER CO
80239-3132
US

IV. Provider business mailing address

12015 E 46TH AVE STE 300
DENVER CO
80239-3132
US

V. Phone/Fax

Practice location:
  • Phone: 720-706-3396
  • Fax:
Mailing address:
  • Phone: 720-706-3396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0006863
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: