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NPI Code Detail

MEDICARE: LAKEISHA LEWIS-VICK LPC-S

MEDICARE: LAKEISHA LEWIS-VICK LPC-S
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
1101YP2500XProfessional Counselor5703OK
2101YP2500XProfessional Counselor80658TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326365040
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKEISHA LEWIS-VICK LPC-S
Provider Business Mailing Address
First Line : 412 E ROSE DR
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-5018
Country : US
Telephone Number : 405-777-3817
Fax Number :
Provider Business Practice Location Address
First Line : 1006 NE 17TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73111-1002
Country : US
Telephone Number : 405-419-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2010
Last Update Date : 09/12/2025

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Directions to “ LAKEISHA LEWIS-VICK LPC-S” Practice Location

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