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General NPI Number Information
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NPI Number | 1457658247
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Entity Type | Individual
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Provider Name | TAWANDA N. LEWIS-HAZAN LPC, LBS
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Gender | Female
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 2613 W MIMI CIR
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City | PHILADELPHIA
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State | PA
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Zip | 19131-2839
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Country | US
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Telephone | 267-477-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 1 UNION AVE BOX 2294
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City | BALA CYNWYD
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State | PA
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Zip | 19004-9998
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Country | US
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Telephone | 267-477-3414
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH000710
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC012170
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC012170
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License Number State | PA
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