Provider Demographics
NPI:1275179152
Name:LEWIS, RONALD LAMOINE (LPC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LAMOINE
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:VENUS
Mailing Address - State:TX
Mailing Address - Zip Code:76084-2100
Mailing Address - Country:US
Mailing Address - Phone:214-551-3249
Mailing Address - Fax:
Practice Address - Street 1:4301 WESTBANK DR STE A250
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-4479
Practice Address - Country:US
Practice Address - Phone:877-504-8504
Practice Address - Fax:855-420-6402
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60388101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional