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General NPI Number Information
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NPI Number | 1104719731
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Entity Type | Individual
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Provider Name | SHAYONNA LEWIS
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 904 N 1ST ST
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City | RICHMOND
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State | VA
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Zip | 23219-1000
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Country | US
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Telephone | 804-368-9783
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 332
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-0332
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Country | US
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Telephone |
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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 |
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License Number State |
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