Healthcare Provider Details

I. General information

NPI: 1841986890
Provider Name (Legal Business Name): MS. KATHERINE MARY LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HEALTHY MINDS, 3602 COLLINS FERRY RD SUITE 150
MORGANTOWN WV
26505
US

IV. Provider business mailing address

HEALTHY MINDS, 3602 COLLINS FERRY RD SUITE 150
MORGANTOWN WV
26505
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-6655
  • Fax:
Mailing address:
  • Phone: 304-598-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number675
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: