Provider Demographics
NPI:1851777270
Name:LEWIN, KELLEY CATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:CATHERINE
Last Name:LEWIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 PAINTED HORSE PASS
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2405
Mailing Address - Country:US
Mailing Address - Phone:901-825-1778
Mailing Address - Fax:
Practice Address - Street 1:1612 PAINTED HORSE PASS
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2405
Practice Address - Country:US
Practice Address - Phone:901-825-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN76431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical