Healthcare Provider Details

I. General information

NPI: 1538549860
Provider Name (Legal Business Name): KASEY LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KASEY KOWCHUCK SPEECH LANGUAGE PATH

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 CARMELL DR
PITTSBURGH PA
15241-1768
US

IV. Provider business mailing address

296 CARMELL DR
PITTSBURGH PA
15241-1768
US

V. Phone/Fax

Practice location:
  • Phone: 571-213-6530
  • Fax:
Mailing address:
  • Phone: 571-213-6530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL012450
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: