Provider Demographics
NPI:1649078718
Name:LEWIS, JANAE' HYNDMAN (LPC-R)
Entity type:Individual
Prefix:
First Name:JANAE'
Middle Name:HYNDMAN
Last Name:LEWIS
Suffix:
Gender:
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BLACKWATER DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2522
Mailing Address - Country:US
Mailing Address - Phone:804-243-9680
Mailing Address - Fax:
Practice Address - Street 1:415 BLACKWATER DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2522
Practice Address - Country:US
Practice Address - Phone:804-243-9680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health