Provider Demographics
NPI:1831498260
Name:LEWIS, MURSHEL C (LSW)
Entity Type:Individual
Prefix:MR
First Name:MURSHEL
Middle Name:C
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:MR
Other - First Name:MURSHEL
Other - Middle Name:C
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:5255 N. ABBE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1451
Mailing Address - Country:US
Mailing Address - Phone:440-934-9930
Mailing Address - Fax:440-934-9645
Practice Address - Street 1:5255 N ABBE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1451
Practice Address - Country:US
Practice Address - Phone:440-934-9930
Practice Address - Fax:440-934-9645
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 0500674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health