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General NPI Number Information
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NPI Number | 1134100035
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Entity Type | Individual
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Provider Name | SUSAN J LEWIS PHD JD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 12567 W CEDAR DR STE 250
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City | LAKEWOOD
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State | CO
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Zip | 80228-2039
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Country | US
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Telephone | 303-691-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 12567 W CEDAR DR STE 250
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City | LAKEWOOD
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State | CO
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Zip | 80228-2039
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Country | US
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Telephone | 617-724-0287
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Fax | 617-726-2894
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6189
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License Number State | MA
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