Provider Demographics
NPI:1346320207
Name:LEWIS, LORENA (LICSW)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17121 SE 270TH PL
Mailing Address - Street 2:SUITE 209
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5431
Mailing Address - Country:US
Mailing Address - Phone:206-406-6768
Mailing Address - Fax:253-631-3976
Practice Address - Street 1:17121 SE 270TH PL
Practice Address - Street 2:SUITE 209
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-5431
Practice Address - Country:US
Practice Address - Phone:206-406-6768
Practice Address - Fax:253-631-3976
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004261101Y00000X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical