Healthcare Provider Details

I. General information

NPI: 1609660240
Provider Name (Legal Business Name): MARIA LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SOUTHWIND PL
MANHATTAN KS
66503-3123
US

IV. Provider business mailing address

1913 M ST
BELLEVILLE KS
66935-2238
US

V. Phone/Fax

Practice location:
  • Phone: 785-560-3101
  • Fax: 785-527-8317
Mailing address:
  • Phone: 785-560-3101
  • Fax: 785-527-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14064
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0903004463
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number89825
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07137500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: