Provider Demographics
NPI:1073873758
Name:LEWIS, CORINNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241-0677
Mailing Address - Country:US
Mailing Address - Phone:860-377-8208
Mailing Address - Fax:
Practice Address - Street 1:19 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:WAUREGAN
Practice Address - State:CT
Practice Address - Zip Code:06387-8700
Practice Address - Country:US
Practice Address - Phone:860-377-8208
Practice Address - Fax:860-412-9138
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0077541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical