Healthcare Provider Details

I. General information

NPI: 1306243886
Provider Name (Legal Business Name): CARLA L LEWIS CADC, C-LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 MAIN ST
LIMESTONE ME
04750-6607
US

IV. Provider business mailing address

1093 W MAIN ST
DOVER FOXCROFT ME
04426-3717
US

V. Phone/Fax

Practice location:
  • Phone: 207-325-4727
  • Fax: 207-325-4308
Mailing address:
  • Phone: 207-922-4600
  • Fax: 207-910-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC5630
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: