Provider Demographics
NPI:1205588092
Name:PHILLIP J. LEWIS, PLLC
Entity type:Organization
Organization Name:PHILLIP J. LEWIS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:JD, BCD, LCSW
Authorized Official - Phone:202-427-8851
Mailing Address - Street 1:208 I ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4340
Mailing Address - Country:US
Mailing Address - Phone:202-427-8851
Mailing Address - Fax:202-929-2833
Practice Address - Street 1:208 I ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4340
Practice Address - Country:US
Practice Address - Phone:202-427-8851
Practice Address - Fax:202-929-2833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHILLIP J. LEWIS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-22
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC339669OtherTAX REGISTRATION CONFORMATION #