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General NPI Number Information
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NPI Number | 1275645665
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Entity Type | Individual
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Provider Name | DEBRA K LEWIS PSYD LP
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 55 E LONG LAKE RD STE 314
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City | TROY
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State | MI
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Zip | 48085-4738
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Country | US
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Telephone | 248-202-3779
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Fax |
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Provider Business Mailing Address
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Address Line | 55 E LONG LAKE RD STE 314
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City | TROY
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State | MI
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Zip | 48085-4738
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Country | US
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Telephone | 248-202-3779
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-00012
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 63010103394
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 63010103394
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License Number State | MI
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