Healthcare Provider Details

I. General information

NPI: 1649824418
Provider Name (Legal Business Name): EMILY CLAIRE LEWIS MA, LPC, FCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7265 KENWOOD RD STE 150
CINCINNATI OH
45236-4411
US

IV. Provider business mailing address

7265 KENWOOD RD STE 150
CINCINNATI OH
45236-4411
US

V. Phone/Fax

Practice location:
  • Phone: 513-549-7732
  • Fax:
Mailing address:
  • Phone: 513-549-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1902091
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: