Provider Demographics
NPI:1639504889
Name:LEWIS, LAKESHIA ANNETTE
Entity Type:Individual
Prefix:
First Name:LAKESHIA
Middle Name:ANNETTE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 I ST SE
Mailing Address - Street 2:11
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4103
Mailing Address - Country:US
Mailing Address - Phone:202-758-3281
Mailing Address - Fax:202-248-2713
Practice Address - Street 1:1214 I ST SE
Practice Address - Street 2:11
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4103
Practice Address - Country:US
Practice Address - Phone:202-758-3281
Practice Address - Fax:202-248-2713
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health