MEDICARE: MRS. JERI DICKINSON LEWIS LPC

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	101YM0800X	Mental Health Counselor	0701002806	VA
2	101YP2500X	Professional Counselor	0701002806	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1902816341	OTHER	VA	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902816341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JERI DICKINSON LEWIS LPC

Provider Business Mailing Address
First Line	:	8426 LEE DAVIS RD
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-6574
Country	:	US
Telephone Number	:	804-398-8401
Fax Number	:	804-789-8881

Provider Business Practice Location Address
First Line	:	7489 RIGHT FLANK RD STE 330
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-3845
Country	:	US
Telephone Number	:	804-398-8401
Fax Number	:	47-898-8818

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	10/25/2024

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