Provider Demographics
NPI:1639150287
Name:LEWIS, TYRONE STEVEN (MS, LMHC,SAP,MAC)
Entity Type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:STEVEN
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MS, LMHC,SAP,MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10239 BOCA BND W
Mailing Address - Street 2:4
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-5412
Mailing Address - Country:US
Mailing Address - Phone:561-852-9235
Mailing Address - Fax:305-558-6134
Practice Address - Street 1:10239 BOCA BND W
Practice Address - Street 2:4
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-5412
Practice Address - Country:US
Practice Address - Phone:561-852-9235
Practice Address - Fax:305-558-6134
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2533101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health