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General NPI Number Information
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NPI Number | 1366186785
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Entity Type | Individual
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Provider Name | KATHERINE B LEWIS LPC, ICADC II, NCC
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Gender | Female
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 210 W JACKSON ST
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City | RIDGELAND
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State | MS
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Zip | 39157-2312
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Country | US
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Telephone | 601-525-6093
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Fax |
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Provider Business Mailing Address
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Address Line | 409 HERNDON RD
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City | LEAKESVILLE
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State | MS
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Zip | 39451-5159
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Country | US
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Telephone | 601-525-6093
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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 | AD18-019L
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1625790
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3080
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License Number State | MS
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