Provider Demographics
NPI:1619157278
Name:LEWIS NEMES PHD LLC
Entity Type:Organization
Organization Name:LEWIS NEMES PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-345-6616
Mailing Address - Street 1:516 BARLANE PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-5402
Mailing Address - Country:US
Mailing Address - Phone:505-345-6616
Mailing Address - Fax:505-765-9010
Practice Address - Street 1:516 BARLANE PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-5402
Practice Address - Country:US
Practice Address - Phone:505-345-6616
Practice Address - Fax:505-765-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-11
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM523261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000N6603Medicaid
NMNM100463OtherVALUE OPTIONS
NM268444OtherMANAGED HEALTH NETWORK
NM89512OtherCIGNA
NMNM00NK04OtherBLUE CROSS BLUE SHIELD
NM201007246OtherPRESBYTERIAN HEALTH PLAN