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NPI Code Detail

MEDICARE: MARCIA LEWIS AMFT #72446

MEDICARE: MARCIA LEWIS AMFT #72446
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
1106H00000XMarriage & Family Therapist72446CA
2101YA0400XAddiction (Substance Use Disorder) CounselorC18491214CA

General Provider Information

NPI Number : 1649681990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIA LEWIS AMFT #72446
Provider Business Mailing Address
First Line : 1730 W OLYMPIC BLVD # 3A-300
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-1019
Country : US
Telephone Number : 213-249-9388
Fax Number : 213-389-7993
Provider Business Practice Location Address
First Line : 44359 PALM ST
Second Line :
City : INDIO
State : CA
Zip : 92201-3116
Country : US
Telephone Number : 760-342-6616
Fax Number : 760-347-8276
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2014
Last Update Date : 03/28/2019

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Directions to “ MARCIA LEWIS AMFT #72446” Practice Location

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