Provider Demographics
NPI:1225299530
Name:LEWIS, MARCIA L (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:L
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:P O BOX 99
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NC
Mailing Address - Zip Code:28788-0099
Mailing Address - Country:US
Mailing Address - Phone:828-586-8958
Mailing Address - Fax:
Practice Address - Street 1:151 DESOTO TRAIL
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-6956
Practice Address - Country:US
Practice Address - Phone:828-586-8958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102457Medicaid