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General NPI Number Information
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NPI Number | 1609149848
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Entity Type | Individual
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Provider Name | KATHYRN LEWIS LPC, CSAC, ICS
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Gender | Female
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4155 COUNTY H
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City | LAONA
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State | WI
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Zip | 54541-9293
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Country | US
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Telephone | 715-674-7656
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Fax |
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Provider Business Mailing Address
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Address Line | 386 EAGLE LAKE RD
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City | PELICAN LAKE
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State | WI
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Zip | 54463-9414
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Country | US
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Telephone | 608-213-3885
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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 | 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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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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