Provider Demographics
NPI:1679837405
Name:LEWIS, YOLANDA N (CSAC,LCAS-A)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:N
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CSAC,LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3149
Mailing Address - Country:US
Mailing Address - Phone:910-739-8849
Mailing Address - Fax:
Practice Address - Street 1:2003 GODWIN AVE STE A
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3150
Practice Address - Country:US
Practice Address - Phone:910-739-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3052-A101YA0400X
NC2216101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)