Provider Demographics
NPI:1831112382
Name:LESTER, LEWIS JAY (LCSW)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:JAY
Last Name:LESTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2298
Mailing Address - Street 2:
Mailing Address - City:REDWAY
Mailing Address - State:CA
Mailing Address - Zip Code:95560-2298
Mailing Address - Country:US
Mailing Address - Phone:707-923-7038
Mailing Address - Fax:707-923-7038
Practice Address - Street 1:615A BEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:GARBERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95542-3102
Practice Address - Country:US
Practice Address - Phone:707-923-7038
Practice Address - Fax:707-923-7038
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 169381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical