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General NPI Number Information
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NPI Number | 1396296422
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Entity Type | Individual
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Provider Name | SAMANTHA LIN LEWIS MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 11949 JEFFERSON BLVD STE 102
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City | CULVER CITY
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State | CA
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Zip | 90230-6336
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Country | US
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Telephone | 714-510-2705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10162
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City | TORRANCE
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State | CA
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Zip | 90505-0962
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Country | US
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Telephone | 714-510-2705
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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 | LPC 2924
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License Number State | CA
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