Provider Demographics
NPI:1174651194
Name:LEWIS, MARLO SHERRIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARLO
Middle Name:SHERRIE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 TRYM ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-5430
Mailing Address - Country:US
Mailing Address - Phone:510-305-9573
Mailing Address - Fax:
Practice Address - Street 1:1848 TRYM ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-5430
Practice Address - Country:US
Practice Address - Phone:510-305-9573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor