Healthcare Provider Details

I. General information

NPI: 1528031713
Provider Name (Legal Business Name): DAVID GEORGE LEWIS LICSW/LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SB - ARMY HEALTH CLINIC - BLDG. 681 2ND FLOOR
SCHOFIELD BARRACKS HI
96857
US

IV. Provider business mailing address

300 WAI NANI WAY APT. # 1517
HONOLULU HI
96815-3983
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8552
  • Fax:
Mailing address:
  • Phone: 808-923-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1429
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: