Provider Demographics
NPI:1417383381
Name:LEWIS, DEBRA P (LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:P
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 HALL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5506
Mailing Address - Country:US
Mailing Address - Phone:248-224-6936
Mailing Address - Fax:
Practice Address - Street 1:8300 HALL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5506
Practice Address - Country:US
Practice Address - Phone:248-224-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health