Healthcare Provider Details

I. General information

NPI: 1952178378
Provider Name (Legal Business Name): CHRISTINA NICOLE LEWIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 PIERPONT ST APT 4
RAHWAY NJ
07065-3150
US

IV. Provider business mailing address

1057 PIERPONT ST APT 4
RAHWAY NJ
07065-3150
US

V. Phone/Fax

Practice location:
  • Phone: 908-821-6263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06973700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: