| Doctor Name: | KIMBERLY ANN LEWIS |
| NPI Number: | 1972942175 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CSAC |
| License Number: | 14548-132 |
| Business Practice Address: | 140 W Main Street The Growing Tree Winneconne, WI - 54986 |
| Business Phone Number: | 9205824000 |
| Business Fax Number: | 8888459581 |
| Mailing Address: | Po Box 486, 140 W Main Street WINNECONNE |
| State: | WI |
| Postal Code: | 54986 |
| Phone Number: | 9205824000 |
| Fax Number: | 8888459581 |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 06/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 14548-132 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |