Doctor Name: | MR. ANDRE L LEWIS |
NPI Number: | 1124048871 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W |
License Number: | 2170-C |
Business Practice Address: | 1308 W 5th Ave Crossett, AR - 716352500 |
Business Phone Number: | 8703646471 |
Business Fax Number: | 8703649753 |
Mailing Address: | 790 Roberts Dr, MONTICELLO |
State: | AR |
Postal Code: | 716555723 |
Phone Number: | 8703646471 |
Fax Number: | 8703649753 |
NPI Enumeration Date: | 07/19/2006 |
NPI Last Update Date: | 08/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2170-C |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |