Provider Demographics
NPI:1619080363
Name:LEWIS, DONNA KEMP (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:KEMP
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N CAUSEWAY BLVD
Mailing Address - Street 2:#304
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1756
Mailing Address - Country:US
Mailing Address - Phone:504-837-3241
Mailing Address - Fax:504-837-9857
Practice Address - Street 1:3801 N CAUSEWAY BLVD
Practice Address - Street 2:#304
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1737
Practice Address - Country:US
Practice Address - Phone:504-837-3241
Practice Address - Fax:504-837-9857
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical