Provider Demographics
NPI:1326458878
Name:TAMIKA LEWIS
Entity Type:Organization
Organization Name:TAMIKA LEWIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-284-7088
Mailing Address - Street 1:13400 RIVERSIDE DR STE 318
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2501
Mailing Address - Country:US
Mailing Address - Phone:818-284-7088
Mailing Address - Fax:818-788-9541
Practice Address - Street 1:13400 RIVERSIDE DR STE 318
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2501
Practice Address - Country:US
Practice Address - Phone:818-284-7088
Practice Address - Fax:818-788-9541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA613111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty