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General NPI Number Information
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NPI Number | 1740401033
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Entity Type | Organization
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Legal Business Name | LEWIS CONSULTING SERVICES, PA
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/26/2018
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Provider Practice Location Address
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Address Line | 4917 WATERS EDGE DR STE 220
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City | RALEIGH
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State | NC
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Zip | 27606
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Country | US
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Telephone | 919-622-1303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1955
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City | CARY
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State | NC
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Zip | 27512-1955
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Country | US
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Telephone | 919-622-1303
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. THERESA O LEWIS
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Credential | PH.D.
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Telephone | 919-622-1303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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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 | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 2866
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2866
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License Number State | NC
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