Provider Demographics
NPI:1720298508
Name:LEWIS, JUNE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:LOUISE
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 1:7210 SW 57TH AVENUE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143
Mailing Address - Country:US
Mailing Address - Phone:305-667-0387
Mailing Address - Fax:305-666-8408
Practice Address - Street 1:7210 SW 57TH AVENUE
Practice Address - Street 2:SUITE 221
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143
Practice Address - Country:US
Practice Address - Phone:305-667-0387
Practice Address - Fax:305-666-8408
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical