Healthcare Provider Details

I. General information

NPI: 1336115211
Provider Name (Legal Business Name): ALBERT THOMAS LEWIS LMSW, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MENTAL HEALTH, DEWITT ARMY HOSPITAL 9501 FARRELL RD.
FORT BELVIOR VA
22060
US

IV. Provider business mailing address

31169 CONLEYS CHAPEL RD
LEWES DE
19958-5512
US

V. Phone/Fax

Practice location:
  • Phone: 703-805-0599
  • Fax:
Mailing address:
  • Phone: 760-270-1279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCA259
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801075672
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: