Provider Demographics
NPI:1700496494
Name:LEWIS, DEBRA JONES (M A COUNSELING ED)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JONES
Last Name:LEWIS
Suffix:
Gender:F
Credentials:M A COUNSELING ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 CHRISTI LAKES CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-3891
Mailing Address - Country:US
Mailing Address - Phone:904-945-8716
Mailing Address - Fax:
Practice Address - Street 1:2416 CHRISTI LAKES CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-3891
Practice Address - Country:US
Practice Address - Phone:904-945-8716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional