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General NPI Number Information
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NPI Number | 1629659099
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Entity Type | Individual
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Provider Name | LORA LEWIS MA, LPC, AT
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Gender | Female
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Dates
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Enumeration Date | 04/17/2021
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Last Update Date | 04/17/2021
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Provider Practice Location Address
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Address Line | 22001 FAIRMOUNT BLVD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44118-4819
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Country | US
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Telephone | 216-269-0346
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Fax |
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Provider Business Mailing Address
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Address Line | 1386 E 43RD ST APT 4
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City | CLEVELAND
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State | OH
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Zip | 44103-1143
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Country | US
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Telephone | 216-269-0346
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | OH
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