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General NPI Number Information
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NPI Number | 1053650887
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Entity Type | Organization
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Legal Business Name | GERALD LEWIS INC.
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Dates
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Enumeration Date | 02/14/2013
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Last Update Date | 05/19/2024
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Provider Practice Location Address
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Address Line | 3000 MURVIHILL RD
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City | VALPARAISO
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State | IN
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Zip | 46383-5960
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Country | US
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Telephone | 219-286-3907
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Fax | 219-286-3911
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Provider Business Mailing Address
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Address Line | 9120 CONNECTICUT ST STE A
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7015
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Country | US
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Telephone | 219-793-1233
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Fax | 219-793-1244
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Authorized Official
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Title or Position | OWNER
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Name | MR. GERALD C. LEWIS
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Credential | CNS
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Telephone | 219-743-3907
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 70000167A
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License Number State | IN
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