Doctor Name: | MR. JONATHAN JAMES LEWIS |
NPI Number: | 1235303991 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W. |
License Number: | 6801082270 |
Business Practice Address: | Highway 163 Kayenta Health Center Kayenta, AZ - 86033 |
Business Phone Number: | 9286974185 |
Business Fax Number: | |
Mailing Address: | Po Box 368, Kayenta Health Center KAYENTA |
State: | AZ |
Postal Code: | 86033 |
Phone Number: | 9286974185 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2008 |
NPI Last Update Date: | 12/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801082270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |