Doctor Name: | MR. THOMAS BRYON LEWIS |
NPI Number: | 1023243201 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED LPC |
License Number: | CS 002023 |
Business Practice Address: | 14377 Woodlake Dr Ste 308 Chesterfield, MO - 630175735 |
Business Phone Number: | 3145766493 |
Business Fax Number: | 3145767319 |
Mailing Address: | 14377 Woodlake Dr, Ste 308 CHESTERFIELD |
State: | MO |
Postal Code: | 630175735 |
Phone Number: | 3145766493 |
Fax Number: | 3145767319 |
NPI Enumeration Date: | 05/18/2009 |
NPI Last Update Date: | 05/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CS 002023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |