MEDICARE: ANGELIA LAWANDA LEWIS

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	$$$$$$$$$	WI

General Provider Information

NPI Number	:	1922960848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIA LAWANDA LEWIS

Provider Business Mailing Address
First Line	:	4162 W GOOD HOPE RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2248
Country	:	US
Telephone Number	:	414-435-4445
Fax Number	:

Provider Business Practice Location Address
First Line	:	4162 W GOOD HOPE RD
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2248
Country	:	US
Telephone Number	:	414-949-6885
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ ANGELIA LAWANDA LEWIS ” Practice Location

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