Healthcare Provider Details
I. General information
NPI: 1326570854
Provider Name (Legal Business Name): KIMBERLY D LEWIS LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2017
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 BRENDAN WAY STE 120
GREENVILLE SC
29615-3562
US
IV. Provider business mailing address
3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US
V. Phone/Fax
- Phone: 916-576-7900
- Fax:
- Phone: 864-549-6191
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC.7398 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: