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General NPI Number Information
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NPI Number | 1053345645
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Entity Type | Individual
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Provider Name | KENT E LEWIS D MIN
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 612 WILSON AVE
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City | TULLAHOMA
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State | TN
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Zip | 37388
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Country | US
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Telephone | 931-455-8504
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Fax | 931-393-2996
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Provider Business Mailing Address
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Address Line | PO BOX 1296
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City | TULLAHOMA
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State | TN
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Zip | 37388
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Country | US
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Telephone | 931-455-8504
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Fax | 931-393-2996
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 215
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 220
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License Number State | TN
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