Provider Demographics
NPI:1831291434
Name:LEWIS, RON (CSW)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:RON
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1811 BETHLEHEM PIKE
Mailing Address - Street 2:STE214
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-1111
Mailing Address - Country:US
Mailing Address - Phone:215-643-0200
Mailing Address - Fax:215-643-9844
Practice Address - Street 1:1811 BETHLEHEM PIKE
Practice Address - Street 2:STE214
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-643-0200
Practice Address - Fax:215-643-9844
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0134501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0227455000OtherPERSONAL CHOICE
PA176363000OtherMAGELLAN
PA0072708210002Medicaid
PA5253586OtherAETNA
PA0227455000OtherPERSONAL CHOICE