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General NPI Number Information
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NPI Number | 1962192229
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Entity Type | Individual
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Provider Name | JESSICA LEWIS MA, LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 6210 SCOTT ST UNIT 115
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City | PUNTA GORDA
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State | FL
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Zip | 33950-3901
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Country | US
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Telephone | 941-780-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 1195 N STEP ST
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City | NORTH PORT
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State | FL
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Zip | 34286-8927
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Country | US
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Telephone | 248-303-3730
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH26270
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License Number State | FL
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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 | IMH23998
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License Number State | FL
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