Provider Demographics
NPI:1033379045
Name:LEWIS, ALLISON FERDINAND (LCSWC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FERDINAND
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 ADAMSVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1136
Mailing Address - Country:US
Mailing Address - Phone:410-303-4651
Mailing Address - Fax:
Practice Address - Street 1:104 CHURCH LN STE 206
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3845
Practice Address - Country:US
Practice Address - Phone:410-303-4651
Practice Address - Fax:410-303-4651
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404580700Medicaid