Provider Demographics
NPI:1760824536
Name:LEWIS, TAMRA WILEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TAMRA
Middle Name:WILEY
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 ROCKERGATE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3452
Mailing Address - Country:US
Mailing Address - Phone:281-438-1515
Mailing Address - Fax:
Practice Address - Street 1:6818 ROCKERGATE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3452
Practice Address - Country:US
Practice Address - Phone:281-438-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67584101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional