Provider Demographics
NPI:1518227198
Name:LEWIS, KAREN (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 CEDAR LN FL 2
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1709
Mailing Address - Country:US
Mailing Address - Phone:201-290-5550
Mailing Address - Fax:
Practice Address - Street 1:416 CEDAR LN FL 2
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-1709
Practice Address - Country:US
Practice Address - Phone:201-290-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055020001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1518227198OtherHORIZON BLUE CROSS BLUE SHIELD
1518227198OtherCIGNA