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NPI Code Detail

MEDICARE: JOLI MICHELLE LEWIS LPC, LADAC

MEDICARE: JOLI MICHELLE LEWIS LPC, LADAC
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 Counselor2019004811MO
2101YM0800XMental Health CounselorP2102157AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NONEOTHERNONE

General Provider Information

NPI Number : 1851599955
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLI MICHELLE LEWIS LPC, LADAC
Provider Business Mailing Address
First Line : PO BOX 1060
Second Line :
City : MARSHALL
State : AR
Zip : 72650-1060
Country : US
Telephone Number : 870-448-5733
Fax Number :
Provider Business Practice Location Address
First Line : 465 MEDICAL CENTER PARKWAY
Second Line :
City : CLINTON
State : AR
Zip : 72031-1529
Country : US
Telephone Number : 501-745-7888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 11/25/2025

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