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General NPI Number Information
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NPI Number | 1497358808
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Entity Type | Individual
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Provider Name | JENNIFER LYNN LEWIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 701 W CANDLEWICK CIR
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City | WEST TERRE HAUTE
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State | IN
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Zip | 47885-9628
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Country | US
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Telephone | 812-205-6418
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W CANDLEWICK CIR
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City | WEST TERRE HAUTE
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State | IN
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Zip | 47885-9628
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Country | US
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Telephone | 812-205-6418
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011350A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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