Provider Demographics
NPI:1588665079
Name:LEWIS, MARK E (LPC LMFT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 N 3RD ST
Mailing Address - Street 2:STE 505
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5833
Mailing Address - Country:US
Mailing Address - Phone:325-672-8883
Mailing Address - Fax:325-675-5833
Practice Address - Street 1:1049 N 3RD ST
Practice Address - Street 2:STE 505
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5833
Practice Address - Country:US
Practice Address - Phone:325-672-8883
Practice Address - Fax:325-675-5833
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14585101YM0800X
TX4878106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist