Provider Demographics
NPI:1528011954
Name:LEWIS, AMY E (MA, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SUNDIAL AVE STE 310W
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7244
Mailing Address - Country:US
Mailing Address - Phone:603-634-9471
Mailing Address - Fax:603-676-2173
Practice Address - Street 1:25 SUNDIAL AVE STE 310W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-7244
Practice Address - Country:US
Practice Address - Phone:603-634-9471
Practice Address - Fax:603-676-2173
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH712101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30427987Medicaid