Provider Demographics
NPI:1093786816
Name:LEWIS, ANNE P (PHD, HSPP LCAC)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHD, HSPP LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10142 BROOKS SCHOOL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-3839
Mailing Address - Country:US
Mailing Address - Phone:317-263-4150
Mailing Address - Fax:844-387-5421
Practice Address - Street 1:10142 BROOKS SCHOOL RD STE 200
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-3839
Practice Address - Country:US
Practice Address - Phone:317-263-4150
Practice Address - Fax:844-387-5421
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 103TC1900X
IN39001745A101YM0800X
IN20042541A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201042020Medicaid
INM400059084Medicare PIN