Provider Demographics
NPI:1174856959
Name:LEWIS, DEBRA GAIL (LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:GAIL
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 OSAGE TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6684
Mailing Address - Country:US
Mailing Address - Phone:928-848-3018
Mailing Address - Fax:214-905-1998
Practice Address - Street 1:8222 DOUGLAS AVE
Practice Address - Street 2:STE. 375
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5923
Practice Address - Country:US
Practice Address - Phone:214-905-5090
Practice Address - Fax:214-905-1998
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health