Provider Demographics
NPI:1972898252
Name:LEWIS, VICTORIA (LCSW)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:LEWIS
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:PO BOX 2988
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70059-2988
Mailing Address - Country:US
Mailing Address - Phone:504-339-0833
Mailing Address - Fax:504-392-3227
Practice Address - Street 1:1448 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2454
Practice Address - Country:US
Practice Address - Phone:504-339-0833
Practice Address - Fax:504-392-3227
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1078101YA0400X
LA3405101YM0800X, 101YP2500X, 1041C0700X
LA101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3405OtherLCSW