Provider Demographics
NPI:1992032080
Name:JAMES LEWIS, M.A., L.C.D.C., P.A.
Entity Type:Organization
Organization Name:JAMES LEWIS, M.A., L.C.D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:713-984-7560
Mailing Address - Street 1:PO BOX 19171
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77224-9171
Mailing Address - Country:US
Mailing Address - Phone:713-984-7560
Mailing Address - Fax:713-984-7576
Practice Address - Street 1:908 TOWN AND COUNTRY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2221
Practice Address - Country:US
Practice Address - Phone:713-984-7560
Practice Address - Fax:713-984-7576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10499101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty