Healthcare Provider Details

I. General information

NPI: 1154733251
Provider Name (Legal Business Name): TERESA LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 MINNESOTA AVE NE
WASHINGTON DC
20019-2662
US

IV. Provider business mailing address

3921 MINN AVE NE
WASHINGTON DC
20019-2662
US

V. Phone/Fax

Practice location:
  • Phone: 202-839-5310
  • Fax: 202-388-9209
Mailing address:
  • Phone: 202-839-5310
  • Fax: 202-388-9209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC1069
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: