Healthcare Provider Details

I. General information

NPI: 1588161855
Provider Name (Legal Business Name): JANE MARCEL LEWIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28488 US HIGHWAY 19 N LOT 8
CLEARWATER FL
33761-2520
US

IV. Provider business mailing address

28488 US HIGHWAY 19 N LOT 8
CLEARWATER FL
33761-2520
US

V. Phone/Fax

Practice location:
  • Phone: 601-941-8454
  • Fax:
Mailing address:
  • Phone: 601-941-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13249
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC11130
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: