Provider Demographics
NPI:1659767291
Name:MICHAEL LEWIS COUNSELING SERVICES
Entity Type:Organization
Organization Name:MICHAEL LEWIS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC-S
Authorized Official - Phone:614-429-7441
Mailing Address - Street 1:1065 OAK ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1255
Mailing Address - Country:US
Mailing Address - Phone:614-429-7441
Mailing Address - Fax:
Practice Address - Street 1:941 CHATHAM LN
Practice Address - Street 2:SUITE #103
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2416
Practice Address - Country:US
Practice Address - Phone:614-429-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0007951261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)