MEDICARE: NATALIE FITZ-GORDON-LEWIS LMHC

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	106H00000X	Marriage & Family Therapist	IMH 13441	FL
2	101YM0800X	Mental Health Counselor	MH15704	FL

General Provider Information

NPI Number	:	1285013508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE FITZ-GORDON-LEWIS LMHC

Provider Business Mailing Address
First Line	:	15641 GREATER TRL
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-8178
Country	:	US
Telephone Number	:	352-250-7114
Fax Number	:

Provider Business Practice Location Address
First Line	:	15641 GREATER TRL
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-8178
Country	:	US
Telephone Number	:	352-250-7114
Fax Number	:

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

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	09/19/2024

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