Healthcare Provider Details

I. General information

NPI: 1700595360
Provider Name (Legal Business Name): NATALIE JESSELINA LEWIS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2022
Last Update Date: 11/22/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24A ESTATE ST. JOHN
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

PO BOX 3912
KINGSHILL VI
00851-3912
US

V. Phone/Fax

Practice location:
  • Phone: 340-227-1911
  • Fax:
Mailing address:
  • Phone: 340-227-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4503
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: