Provider Demographics
NPI:1841499043
Name:LEWIS, JENNIFER ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 S FORT THOMAS AVE
Mailing Address - Street 2:PTSD PROGRAM 2ND FLOOR
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2305
Mailing Address - Country:US
Mailing Address - Phone:513-861-3100
Mailing Address - Fax:859-572-6748
Practice Address - Street 1:1000 S FORT THOMAS AVE
Practice Address - Street 2:PTSD PROGRAM 2ND FLOOR
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-2305
Practice Address - Country:US
Practice Address - Phone:513-861-3100
Practice Address - Fax:859-572-6748
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6356103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical