Provider Demographics
NPI:1942463310
Name:LEWIS, HEATHER RENEE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:RENEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:RENEE
Other - Last Name:ERKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 8744
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-8744
Mailing Address - Country:US
Mailing Address - Phone:661-400-5776
Mailing Address - Fax:
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1356
Practice Address - Country:US
Practice Address - Phone:530-744-5525
Practice Address - Fax:877-489-0878
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61155907106H00000X
CA78636106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist