Provider Demographics
NPI:1003397928
Name:LEWIS, STEPHANIE M (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5413
Mailing Address - Country:US
Mailing Address - Phone:603-865-1321
Mailing Address - Fax:603-865-1327
Practice Address - Street 1:ONE BRIDGE STREET
Practice Address - Street 2:THE ENTERPRISE CENTER
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-865-1321
Practice Address - Fax:603-865-1327
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077550Medicaid