Provider Demographics
NPI:1003992827
Name:LEWIS, CINDY WARREN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:WARREN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DUANE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1412
Mailing Address - Country:US
Mailing Address - Phone:617-964-0978
Mailing Address - Fax:
Practice Address - Street 1:500 VICTORY ROAD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171
Practice Address - Country:US
Practice Address - Phone:617-774-1054
Practice Address - Fax:617-847-0915
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1022038104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker