Healthcare Provider Details

I. General information

NPI: 1588872535
Provider Name (Legal Business Name): KATHY ANN LEWANDOWSKI MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY ANN SOUZA MA

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 PLEASANT ST
NEW BEDFORD MA
02740-6728
US

IV. Provider business mailing address

66 TROY ST SUITE 4 & 5
FALL RIVER MA
02720-3023
US

V. Phone/Fax

Practice location:
  • Phone: 508-996-8572
  • Fax: 508-991-8618
Mailing address:
  • Phone: 508-676-5708
  • Fax: 508-676-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: