Healthcare Provider Details

I. General information

NPI: 1528975364
Provider Name (Legal Business Name): MRS. TERRI J LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W MEINECKE AVE
MILWAUKEE WI
53206-3137
US

IV. Provider business mailing address

5715 W ROOSEVELT DR
MILWAUKEE WI
53216-3155
US

V. Phone/Fax

Practice location:
  • Phone: 414-252-0373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number1041S0200X
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: