Provider Demographics
NPI:1558790279
Name:LEWIS, WILLIAM HOWARD (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HOWARD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 43RD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5018
Mailing Address - Country:US
Mailing Address - Phone:718-389-5100
Mailing Address - Fax:718-361-5905
Practice Address - Street 1:2215 43RD AVE FL 2
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5018
Practice Address - Country:US
Practice Address - Phone:718-389-5100
Practice Address - Fax:718-361-5905
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical