Healthcare Provider Details

I. General information

NPI: 1760311641
Provider Name (Legal Business Name): CHELSEA LEWIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7845 OAKWOOD RD STE 202
GLEN BURNIE MD
21061-4257
US

IV. Provider business mailing address

7845 OAKWOOD RD STE 202
GLEN BURNIE MD
21061-4257
US

V. Phone/Fax

Practice location:
  • Phone: 443-628-8346
  • Fax: 443-557-1761
Mailing address:
  • Phone: 443-628-8346
  • Fax: 443-557-1761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17905
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: