Healthcare Provider Details

I. General information

NPI: 1265481956
Provider Name (Legal Business Name): MR. RICHARD D. LEWIS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 NORTH ST
NEW BEDFORD MA
02740-2766
US

IV. Provider business mailing address

26 DELANO RD
MARION MA
02738-2011
US

V. Phone/Fax

Practice location:
  • Phone: 508-984-5566
  • Fax:
Mailing address:
  • Phone: 508-984-5566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC-2903
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLADC1-1364
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLM4281
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: