Provider Demographics
NPI:1821281817
Name:LEWIS, KIM FRANCINE (MH COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:FRANCINE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MH COUNSELOR
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:FRANCINE
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3900 CITY LINE AVE APT D307
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2951
Mailing Address - Country:US
Mailing Address - Phone:215-877-7465
Mailing Address - Fax:
Practice Address - Street 1:3900 CITY LINE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19004
Practice Address - Country:US
Practice Address - Phone:215-877-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health