Healthcare Provider Details

I. General information

NPI: 1437079761
Provider Name (Legal Business Name): MS. DELNITA LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E ROSE ST
LAKELAND FL
33801-2016
US

IV. Provider business mailing address

2318 CAMPUS LAKE CT APT 204
TAMPA FL
33612-6488
US

V. Phone/Fax

Practice location:
  • Phone: 863-413-3126
  • Fax:
Mailing address:
  • Phone: 414-517-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: