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NPI Code Detail

MEDICARE: LISA ELIZABETH LEWIS LCSW

MEDICARE: LISA ELIZABETH LEWIS LCSW
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
11041C0700XClinical Social Worker1382-CAR

General Provider Information

NPI Number : 1700977741
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ELIZABETH LEWIS LCSW
Provider Business Mailing Address
First Line : 2700 GRIST MILL RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72227-3823
Country : US
Telephone Number : 501-219-5153
Fax Number :
Provider Business Practice Location Address
First Line : 1405 N PIERCE ST
Second Line : SUITE 101
City : LITTLE ROCK
State : AR
Zip : 72207-5349
Country : US
Telephone Number : 501-603-2147
Fax Number : 501-603-0324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/08/2007

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Directions to “ LISA ELIZABETH LEWIS LCSW” Practice Location

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