Provider Demographics
NPI:1790709426
Name:LEWIS, VALERIE J (LPC)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:J
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 1:15617 SUMMIT PARKE DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1353
Mailing Address - Country:US
Mailing Address - Phone:405-231-3150
Mailing Address - Fax:405-231-3157
Practice Address - Street 1:15617 SUMMIT PARKE DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1353
Practice Address - Country:US
Practice Address - Phone:405-231-3150
Practice Address - Fax:405-231-3157
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1849104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker