=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518152891
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEWE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2007
-----------------------------------------------------
Last Update Date | 09/11/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2080 WEST ARLINGTON BLVD STE A
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-2080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-439-2275
-----------------------------------------------------
Fax | 252-439-2353
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2080A W ARLINGTON BLVD STE A
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-5779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-439-2275
-----------------------------------------------------
Fax | 252-439-2353
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/DIRECTOR
-----------------------------------------------------
Name | MS. GERALDINE MONK JONES
-----------------------------------------------------
Credential | MA IN BUSINESS
-----------------------------------------------------
Telephone | 252-439-2275
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------