Provider Demographics
NPI:1043732704
Name:LEWIS, LINDSAY FAITH FIELDS (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:FAITH FIELDS
Last Name:LEWIS
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:FIELDS
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCABA
Mailing Address - Street 1:3800 HILLSBOROUGH STREET
Mailing Address - Street 2:LEDFORD 004
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5237
Mailing Address - Country:US
Mailing Address - Phone:919-760-8074
Mailing Address - Fax:919-760-8818
Practice Address - Street 1:3800 HILLSBOROUGH ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5237
Practice Address - Country:US
Practice Address - Phone:919-760-8074
Practice Address - Fax:919-760-8818
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0-17-7836106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1194858761OtherNPI -MEREDITH AUTISM PROGRAM