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General NPI Number Information
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NPI Number | 1033711387
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Entity Type | Individual
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Provider Name | BENJAMIN ROSS LEWIS LPC
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Gender | Male
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 5901 LONG DR
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City | HOUSTON
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State | TX
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Zip | 77087-1003
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Country | US
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Telephone | 713-970-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 624 MORRISON DR
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City | LIVINGSTON
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State | TX
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Zip | 77351-4342
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Country | US
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Telephone | 936-328-7109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 79807
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License Number State | TX
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