Provider Demographics
NPI:1831703875
Name:LEWIS-HAWKINS, STEPHANIE SHAVON
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SHAVON
Last Name:LEWIS-HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STATON DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1717
Mailing Address - Country:US
Mailing Address - Phone:240-417-8675
Mailing Address - Fax:
Practice Address - Street 1:10123 SENATE DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4367
Practice Address - Country:US
Practice Address - Phone:240-417-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor