Healthcare Provider Details

I. General information

NPI: 1790700011
Provider Name (Legal Business Name): GERMAINE MARIE LEWIS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 BUCCANEER MALL STE 8
ST THOMAS VI
00802-2402
US

IV. Provider business mailing address

PO BOX 305165
ST THOMAS VI
00803-5165
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-5017
  • Fax: 340-774-5384
Mailing address:
  • Phone: 340-774-5017
  • Fax: 340-774-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1-2017972-2006
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: