MEDICARE: SAVANNAH LEWIS 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
1	101Y00000X	Counselor	P2104011	AR
2	101YM0800X	Mental Health Counselor	P2104011	AR

General Provider Information

NPI Number	:	1467866186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH LEWIS LPC-S

Provider Business Mailing Address
First Line	:	1600 ALDERSGATE RD STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-6676
Country	:	US
Telephone Number	:	501-661-0720
Fax Number	:	501-325-7938

Provider Business Practice Location Address
First Line	:	617 E NORTH ST
Second Line	:
City	:	MAGNOLIA
State	:	AR
Zip	:	71753-3120
Country	:	US
Telephone Number	:	870-234-0739
Fax Number	:	870-234-0739

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	11/17/2025

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Directions to “ SAVANNAH LEWIS LPC-S” Practice Location

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