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General NPI Number Information
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NPI Number | 1598350829
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Entity Type | Individual
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Provider Name | JANICE ROCHELLE LEWIS MSW
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Gender | Female
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 320 NW MARTIN LUTHER KING JR BLVD
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City | EVANSVILLE
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State | IN
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Zip | 47708-1999
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Country | US
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Telephone | 812-893-0772
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Fax |
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Provider Business Mailing Address
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Address Line | 5009 E RIVERSIDE DR APT C
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City | EVANSVILLE
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State | IN
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Zip | 47715-6794
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Country | US
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Telephone | 901-833-5546
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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 | 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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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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