Provider Demographics
NPI:1467185116
Name:LEWIS, CHELSY (CIT)
Entity Type:Individual
Prefix:MS
First Name:CHELSY
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CHOUDRANT
Mailing Address - State:LA
Mailing Address - Zip Code:71227-8628
Mailing Address - Country:US
Mailing Address - Phone:318-243-9200
Mailing Address - Fax:318-224-7135
Practice Address - Street 1:330 E VAUGHN AVE
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-5928
Practice Address - Country:US
Practice Address - Phone:318-224-7135
Practice Address - Fax:318-224-7135
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty