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General NPI Number Information
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NPI Number | 1679452932
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Entity Type | Organization
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Legal Business Name | LEWIS FAMILY WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/30/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 7150 E CAMELBACK RD STE 444
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-1257
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Country | US
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Telephone | 763-691-9002
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Fax | 763-226-2390
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Provider Business Mailing Address
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Address Line | 3181 BERWICK KNL STE 15
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-1960
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Country | US
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Telephone | 763-843-5403
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Fax | 763-843-5403
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Authorized Official
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Title or Position | OWNER
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Name | CERISE DIONE LEWIS
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Credential |
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Telephone | 763-691-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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