Healthcare Provider Details

I. General information

NPI: 1841791019
Provider Name (Legal Business Name): ANYA LETTICE LEWIS LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 WOODWARD AVE
DETROIT MI
48202-2142
US

IV. Provider business mailing address

11672 WESTWOOD ST
DETROIT MI
48228-1353
US

V. Phone/Fax

Practice location:
  • Phone: 313-875-7601
  • Fax: 313-871-8191
Mailing address:
  • Phone: 313-681-3532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851102215
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: