Provider Demographics
NPI:1073058038
Name:CRAIG LEWIS COUNSELING, LLC
Entity Type:Organization
Organization Name:CRAIG LEWIS COUNSELING, LLC
Other - Org Name:GOLDEN OUTLOOK COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-860-1661
Mailing Address - Street 1:3850 WALKER BLVD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1627
Mailing Address - Country:US
Mailing Address - Phone:814-616-3199
Mailing Address - Fax:
Practice Address - Street 1:3850 WALKER BLVD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1627
Practice Address - Country:US
Practice Address - Phone:814-616-3199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008914251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health