Healthcare Provider Details

I. General information

NPI: 1487091153
Provider Name (Legal Business Name): RICHARD C LEWIS L.C.S.W
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 E 230TH ST
BRONX NY
10466-4616
US

IV. Provider business mailing address

954 E 230TH ST
BRONX NY
10466-4616
US

V. Phone/Fax

Practice location:
  • Phone: 347-476-6682
  • Fax:
Mailing address:
  • Phone: 347-476-6682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number088393
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: