Provider Demographics
NPI:1083987408
Name:LEWIS, CHENEISHA (LPC, LCADC)
Entity Type:Individual
Prefix:MS
First Name:CHENEISHA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SPEAR RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1235
Mailing Address - Country:US
Mailing Address - Phone:201-658-3434
Mailing Address - Fax:
Practice Address - Street 1:19 SPEAR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1235
Practice Address - Country:US
Practice Address - Phone:201-658-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00440400101YP2500X
NJ37LC00186800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)