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General NPI Number Information
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NPI Number | 1114489432
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Entity Type | Organization
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Legal Business Name | LATRICE R. LEWIS, LLC
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 390 COMMERCE DR # 340
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City | FORT WASHINGTON
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State | PA
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Zip | 19034-2600
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Country | US
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Telephone | 215-687-7050
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Fax | 215-330-4008
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Provider Business Mailing Address
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Address Line | PO BOX 4044
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City | PHILADELPHIA
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State | PA
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Zip | 19118-8044
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Country | US
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Telephone | 215-687-7050
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. LATRICE R. LEWIS
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Credential | MA, LPC
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Telephone | 215-687-7050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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