Provider Demographics
NPI:1164046322
Name:LEWIS, AMELIA (LMFT, LCDC-I)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 100TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-7153
Mailing Address - Country:US
Mailing Address - Phone:214-883-7944
Mailing Address - Fax:
Practice Address - Street 1:6520 UNIVERSITY AVE SPC 5
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5811
Practice Address - Country:US
Practice Address - Phone:214-883-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health