Provider Demographics
NPI:1114210382
Name:LEWIS, TAMECA LASHAE
Entity Type:Individual
Prefix:
First Name:TAMECA
Middle Name:LASHAE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 S MAY AVE APT 287
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73119-5676
Mailing Address - Country:US
Mailing Address - Phone:405-427-2523
Mailing Address - Fax:
Practice Address - Street 1:3140 W BRITTON RD STE 204
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2039
Practice Address - Country:US
Practice Address - Phone:405-608-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-22
Last Update Date:2011-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor