=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821974171
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NKRUMAH D. LEWIS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2007 BOULEVARD ST STE E
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27407-4695
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-355-8423
-----------------------------------------------------
Fax | 336-450-1833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2007 BOULEVARD ST STE E
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27407-4695
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-355-8423
-----------------------------------------------------
Fax | 336-450-1833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOTHERAPIST
-----------------------------------------------------
Name | DR. NKRUMAH D'ANGELO LEWIS
-----------------------------------------------------
Credential | PHD, LCSW
-----------------------------------------------------
Telephone | 336-355-8423
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------