Provider Demographics
NPI:1083142806
Name:LEWIS, ROXANNE ERICA (MSW)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:ERICA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18801 E MAINSTREET STE 180
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3477
Mailing Address - Country:US
Mailing Address - Phone:303-317-3088
Mailing Address - Fax:
Practice Address - Street 1:18801 E MAINSTREET STE 180
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3477
Practice Address - Country:US
Practice Address - Phone:303-317-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0107516104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO104100000XOtherN/A