MEDICARE: WHITNEY LEWIS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner
2	1041C0700X	Clinical Social Worker	L8480	OR
3	1041C0700X	Clinical Social Worker	6960-C	NV

General Provider Information

NPI Number	:	1033451596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY LEWIS LCSW

Provider Business Mailing Address
First Line	:	1334 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3310
Country	:	US
Telephone Number	:	702-530-6413
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 S MARYLAND PKWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3310
Country	:	US
Telephone Number	:	702-530-6413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2013
Last Update Date	:	03/04/2023

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Directions to “ WHITNEY LEWIS LCSW” Practice Location

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