Provider Demographics
NPI:1326488107
Name:LEWIS, CHELSEA L (AUD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:LEWIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6012
Mailing Address - Country:US
Mailing Address - Phone:910-762-8754
Mailing Address - Fax:910-762-3291
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10636231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7010959OtherAETNA
NCQ513925874OtherMEDICARE
NC183G3OtherBCBSNC
NCP01287958OtherRAILROAD MEDICARE
SC1047900OtherWELLCARE OF SC
SCSAN110Medicaid
NC3004675OtherCIGNA
SC30159560OtherSELECT HEALTH OF SC
NC183G3OtherBCBSNC