Healthcare Provider Details

I. General information

NPI: 1558937805
Provider Name (Legal Business Name): AMY S LEWIS MSHE, CHES, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 05/27/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37450 SCHOOLCRAFT RD STE 170
LIVONIA MI
48150-1081
US

IV. Provider business mailing address

37450 SCHOOLCRAFT RD STE 170
LIVONIA MI
48150-1081
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-0170
  • Fax: 734-744-0171
Mailing address:
  • Phone: 734-744-0170
  • Fax: 734-744-0171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: