Provider Demographics
NPI:1366044166
Name:LEWIS, VALENCIA B (LMSW)
Entity Type:Individual
Prefix:
First Name:VALENCIA
Middle Name:B
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6083 RED SQUIRREL PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4444
Mailing Address - Country:US
Mailing Address - Phone:301-456-5058
Mailing Address - Fax:
Practice Address - Street 1:6083 RED SQUIRREL PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4444
Practice Address - Country:US
Practice Address - Phone:301-456-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker