Healthcare Provider Details

I. General information

NPI: 1326017229
Provider Name (Legal Business Name): SUE MAXWELL LEWIS M.ED., LMHC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 MAIN ST SUITE 213A
WAREHAM MA
02571-2166
US

IV. Provider business mailing address

191 MAIN ST SUITE 213A
WAREHAM MA
02571-2166
US

V. Phone/Fax

Practice location:
  • Phone: 508-291-2007
  • Fax:
Mailing address:
  • Phone: 508-291-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number652
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1068
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: