Healthcare Provider Details

I. General information

NPI: 1386704807
Provider Name (Legal Business Name): DEBORAH G LEWIS LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 BOSTON ST SUITE 7
TOPSFIELD MA
01969
US

IV. Provider business mailing address

462 BOSTON ST SUITE 7
TOPSFIELD MA
01983
US

V. Phone/Fax

Practice location:
  • Phone: 978-887-0079
  • Fax: 978-463-0009
Mailing address:
  • Phone: 978-887-0079
  • Fax: 978-463-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106745
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: