Provider Demographics
NPI:1598865370
Name:LEWIS, LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 PINE STREET
Mailing Address - Street 2:PENDLETON COMMUNITY CARE
Mailing Address - City:FRANKLIN
Mailing Address - State:WV
Mailing Address - Zip Code:26807
Mailing Address - Country:US
Mailing Address - Phone:304-358-2355
Mailing Address - Fax:
Practice Address - Street 1:314 PINE STREET
Practice Address - Street 2:PENDLETON COMMUNITY CARE
Practice Address - City:FRANKLIN
Practice Address - State:WV
Practice Address - Zip Code:26807
Practice Address - Country:US
Practice Address - Phone:304-358-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009416671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical