Provider Demographics
NPI:1811099393
Name:LEWIS, ESTELLE (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:ESTELLE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 HYLAN BLVD # 171
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4658
Mailing Address - Country:US
Mailing Address - Phone:718-500-4919
Mailing Address - Fax:518-677-1803
Practice Address - Street 1:2744 HYLAN BLVD # 171
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4658
Practice Address - Country:US
Practice Address - Phone:917-916-9910
Practice Address - Fax:518-677-1803
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040752-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical