Provider Demographics
NPI:1275028185
Name:LEWIS, LEAH N (LCPC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:N
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 BROOKLANE DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1514
Mailing Address - Country:US
Mailing Address - Phone:301-733-0330
Mailing Address - Fax:
Practice Address - Street 1:5301 BUCKEYSTOWN PIKE STE 170
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704
Practice Address - Country:US
Practice Address - Phone:301-733-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8875101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional