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General NPI Number Information
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NPI Number | 1548754336
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Entity Type | Individual
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Provider Name | PASSION LEWIS MSW, PSW, ITDS
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Gender | Female
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 101 SE 2ND PL STE 202
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City | GAINESVILLE
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State | FL
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Zip | 32601-6592
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Country | US
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Telephone | 470-485-1582
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 SW 9TH ST APT G3
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City | GAINESVILLE
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State | FL
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Zip | 32601-0805
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Country | US
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Telephone |
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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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 | PSW1433
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License Number State | FL
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