Provider Demographics
NPI:1629323969
Name:LEWIS, MARJORIE BARBARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:BARBARA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DOWNING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1573
Mailing Address - Country:US
Mailing Address - Phone:303-831-4500
Mailing Address - Fax:303-831-4499
Practice Address - Street 1:1600 DOWNING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1573
Practice Address - Country:US
Practice Address - Phone:303-831-4500
Practice Address - Fax:303-831-4499
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44101YA0400X
CO624106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)