Provider Demographics
NPI:1902226558
Name:LEWIS, CAROLAND (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:CAROLAND
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 REED CT
Mailing Address - Street 2:24 REED COURT
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1662
Mailing Address - Country:US
Mailing Address - Phone:860-983-5897
Mailing Address - Fax:
Practice Address - Street 1:24 REED CT
Practice Address - Street 2:24 REED COURT
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1662
Practice Address - Country:US
Practice Address - Phone:860-983-5897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical