Healthcare Provider Details

I. General information

NPI: 1073396925
Provider Name (Legal Business Name): AMY M LEWIS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BAY ST
BEAUFORT SC
29902-5569
US

IV. Provider business mailing address

1011 BAY ST
BEAUFORT SC
29902-5569
US

V. Phone/Fax

Practice location:
  • Phone: 864-549-0222
  • Fax:
Mailing address:
  • Phone: 843-263-3378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8342
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: