Provider Demographics
NPI:1467578567
Name:LEWIS, ROCKY J (MS LMFT)
Entity Type:Individual
Prefix:MR
First Name:ROCKY
Middle Name:J
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22231 MULHOLLAND HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302
Mailing Address - Country:US
Mailing Address - Phone:818-577-9751
Mailing Address - Fax:818-222-3896
Practice Address - Street 1:22231 MULHOLLAND HWY.
Practice Address - Street 2:SUITE 200
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302
Practice Address - Country:US
Practice Address - Phone:818-577-9751
Practice Address - Fax:818-222-3896
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261106H00000X
CAMFC45808106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist