Provider Demographics
NPI:1184231466
Name:LEWIS, STEVEN ALEXANDER (MS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALEXANDER
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 S ROAN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-7678
Mailing Address - Country:US
Mailing Address - Phone:423-302-0541
Mailing Address - Fax:
Practice Address - Street 1:2700 S ROAN ST STE 400
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-7678
Practice Address - Country:US
Practice Address - Phone:423-302-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2022-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician