Provider Demographics
NPI:1659183911
Name:LEWIS, KASSANDRA M
Entity type:Individual
Prefix:
First Name:KASSANDRA
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 E 44TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6006
Mailing Address - Country:US
Mailing Address - Phone:440-789-4146
Mailing Address - Fax:
Practice Address - Street 1:1808 E 44TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6006
Practice Address - Country:US
Practice Address - Phone:440-789-4146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker