Provider Demographics
NPI:1811672223
Name:LEWIS, ERICA SHAI (LICSW)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:SHAI
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 WATERWEEP DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4266
Mailing Address - Country:US
Mailing Address - Phone:662-374-9909
Mailing Address - Fax:
Practice Address - Street 1:116 WATERWEEP DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4266
Practice Address - Country:US
Practice Address - Phone:662-374-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5243C-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical