Healthcare Provider Details

I. General information

NPI: 1255276929
Provider Name (Legal Business Name): TERESA ANN LEWIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 HILL RD
N TONAWANDA NY
14120-1366
US

IV. Provider business mailing address

3920 HILL RD
N TONAWANDA NY
14120-1366
US

V. Phone/Fax

Practice location:
  • Phone: 716-228-5255
  • Fax:
Mailing address:
  • Phone: 716-228-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: