Provider Demographics
NPI:1952320426
Name:LESTER, LEWIS FREDERICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:FREDERICK
Last Name:LESTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-0657
Mailing Address - Country:US
Mailing Address - Phone:207-621-0865
Mailing Address - Fax:
Practice Address - Street 1:76 EASTERN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5846
Practice Address - Country:US
Practice Address - Phone:207-621-0865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS00000168103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MER29402Medicare UPIN
ME702135Medicare ID - Type Unspecified