MEDICARE: SHARON V 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	101YP2500X	Professional Counselor	3802	CO

General Provider Information

NPI Number	:	1992874903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON V LEWIS LPC

Provider Business Mailing Address
First Line	:	5648 CHARLOTTE PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-3411
Country	:	US
Telephone Number	:	719-574-8370
Fax Number	:

Provider Business Practice Location Address
First Line	:	2864 S CIRCLE DR
Second Line	:	SUITE 600
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4114
Country	:	US
Telephone Number	:	719-314-4260
Fax Number	:	719-264-6616

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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