Provider Demographics
NPI:1003614488
Name:LEWIS, LEKESHIA
Entity type:Individual
Prefix:
First Name:LEKESHIA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BLACK WATER RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-1723
Mailing Address - Country:US
Mailing Address - Phone:337-703-7574
Mailing Address - Fax:
Practice Address - Street 1:205 BLACK WATER RIVER DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-1723
Practice Address - Country:US
Practice Address - Phone:337-703-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator