Provider Demographics
NPI:1558497487
Name:HOUSE, LEW (LCPC)
Entity Type:Individual
Prefix:MR
First Name:LEW
Middle Name:
Last Name:HOUSE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2678 S STONEHEDGE DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-1215
Mailing Address - Country:US
Mailing Address - Phone:208-697-1915
Mailing Address - Fax:
Practice Address - Street 1:511 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:ID
Practice Address - Zip Code:83644-5545
Practice Address - Country:US
Practice Address - Phone:208-697-1915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 3822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional