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NPI Code Detail

MEDICARE: DR. DEBRA K LEWIS PSYD LP

MEDICARE:  DR. DEBRA K LEWIS  PSYD LP
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
1101YA0400XAddiction (Substance Use Disorder) CounselorC-00012MI
2103T00000XPsychologist63010103394MI
3103TC0700XClinical Psychologist63010103394MI

General Provider Information

NPI Number : 1275645665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA K LEWIS PSYD LP
Provider Business Mailing Address
First Line : 55 E LONG LAKE RD STE 314
Second Line :
City : TROY
State : MI
Zip : 48085-4738
Country : US
Telephone Number : 248-202-3779
Fax Number :
Provider Business Practice Location Address
First Line : 55 E LONG LAKE RD STE 314
Second Line :
City : TROY
State : MI
Zip : 48085-4738
Country : US
Telephone Number : 248-202-3779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/22/2025

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Directions to “ DR. DEBRA K LEWIS PSYD LP” Practice Location

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