Provider Demographics
NPI:1821833021
Name:LEWIS, LYNNAY SIERRA (LPC)
Entity type:Individual
Prefix:
First Name:LYNNAY
Middle Name:SIERRA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6202 ANNA PARK DR APT 202
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-8327
Mailing Address - Country:US
Mailing Address - Phone:804-300-8463
Mailing Address - Fax:
Practice Address - Street 1:1519 HUGUENOT RD STE 200
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2472
Practice Address - Country:US
Practice Address - Phone:804-404-8222
Practice Address - Fax:804-925-2574
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013698101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor