Provider Demographics
NPI:1346555356
Name:LEWIS, LYNN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9841 BROKEN LAND PKWY
Mailing Address - Street 2:SUITE #113
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3060
Mailing Address - Country:US
Mailing Address - Phone:410-381-2212
Mailing Address - Fax:
Practice Address - Street 1:9841 BROKEN LAND PKWY
Practice Address - Street 2:SUITE #113
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3060
Practice Address - Country:US
Practice Address - Phone:410-381-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD048441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical