Provider Demographics
NPI:1245343391
Name:LEWCHANIN, SHARI LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LEE
Last Name:LEWCHANIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 STORER ST
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6837
Mailing Address - Country:US
Mailing Address - Phone:207-985-4854
Mailing Address - Fax:207-985-4854
Practice Address - Street 1:44 STORER ST
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6837
Practice Address - Country:US
Practice Address - Phone:207-985-4854
Practice Address - Fax:207-985-4854
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME460103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME003545OtherANTHEM
MEMM4510Medicare ID - Type Unspecified