Provider Demographics
NPI:1083310239
Name:LEWIS, MARRIKA (MSW,LCSW,CCM)
Entity Type:Individual
Prefix:
First Name:MARRIKA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSW,LCSW,CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 JASMINE VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6680
Mailing Address - Country:US
Mailing Address - Phone:919-931-9328
Mailing Address - Fax:
Practice Address - Street 1:1212 JASMINE VIEW WAY
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6680
Practice Address - Country:US
Practice Address - Phone:919-931-9328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0116311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical