Provider Demographics
NPI:1477876522
Name:LEWIS, LINDSEY ELLEN (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ELLEN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43900 GARFIELD RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1128
Mailing Address - Country:US
Mailing Address - Phone:586-263-1234
Mailing Address - Fax:586-263-3412
Practice Address - Street 1:44899 CENTRE CT
Practice Address - Street 2:SUITE 102
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5510
Practice Address - Country:US
Practice Address - Phone:586-792-1654
Practice Address - Fax:586-792-1656
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011760101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional