Healthcare Provider Details

I. General information

NPI: 1972402352
Provider Name (Legal Business Name): LEWIS BIAS JR. CSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 S 900 E
MURRAY UT
84117-5703
US

IV. Provider business mailing address

3539 IOWA AVE
OGDEN UT
84403-2159
US

V. Phone/Fax

Practice location:
  • Phone: 801-869-1095
  • Fax: 801-479-9268
Mailing address:
  • Phone: 385-326-6109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14061790-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: