Provider Demographics
NPI:1306010392
Name:LEWIS, ALTAMIT (LCPC)
Entity Type:Individual
Prefix:
First Name:ALTAMIT
Middle Name:
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 1:6532 GUMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-4415
Mailing Address - Country:US
Mailing Address - Phone:702-499-6401
Mailing Address - Fax:
Practice Address - Street 1:6532 GUMWOOD RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4415
Practice Address - Country:US
Practice Address - Phone:702-499-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3744101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCP0086OtherNEVADA BOARD OF EXAMINERS
MDLC3744OtherLCPC
DCPRC14337OtherDC DEPARTMENT OF HEALTH