Healthcare Provider Details

I. General information

NPI: 1326963729
Provider Name (Legal Business Name): CARRIE ANN LEWIS MHC-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 PRATHER AVE
JAMESTOWN NY
14701-6820
US

IV. Provider business mailing address

206 S ELMWOOD AVE
BUFFALO NY
14201-2398
US

V. Phone/Fax

Practice location:
  • Phone: 716-664-7855
  • Fax:
Mailing address:
  • Phone: 716-847-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP144965
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: