Provider Demographics
NPI:1922193952
Name:LEWELLEN, LUCINDA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:
Last Name:LEWELLEN
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 1:2202 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6912
Mailing Address - Country:US
Mailing Address - Phone:254-771-4246
Mailing Address - Fax:254-771-4246
Practice Address - Street 1:1305 S 33RD ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-6763
Practice Address - Country:US
Practice Address - Phone:254-771-4246
Practice Address - Fax:254-771-4246
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX057301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical