Provider Demographics
NPI:1255530747
Name:LEWIS, BRITT (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRITT
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 1:360 FOUNTAIN ST APT 32
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2611
Mailing Address - Country:US
Mailing Address - Phone:203-415-9712
Mailing Address - Fax:
Practice Address - Street 1:34 PARK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1109
Practice Address - Country:US
Practice Address - Phone:203-974-7371
Practice Address - Fax:203-974-7322
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0078721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT007872OtherSTATE LICENSE