Provider Demographics
NPI:1477194256
Name:LEWANDOWSKI, MATTHEW (LPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:LEWANDOWSKI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 AGLER RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3397
Mailing Address - Country:US
Mailing Address - Phone:614-600-2708
Mailing Address - Fax:614-476-6708
Practice Address - Street 1:3433 AGLER RD STE 2000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3397
Practice Address - Country:US
Practice Address - Phone:614-600-2708
Practice Address - Fax:614-476-6708
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902265101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional