Lewis, Michele

Lewis, Michele is an sole proprietor health care provider with primary practice located at 640 Bartlett Avenue Lower Level, Baltimore MD 21218-5412. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Lewis, Michele can be contacted via phone (443) 613-0506.

Contact Information

Primary practice address
640 Bartlett Avenue Lower Level Baltimore MD 21218-5412
Phone: (443) 613-0506
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1079 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LCA2207 Maryland

Profile Details

NPI number 1417037334
LBN Legal business name Lewis, Michele
Credentials M.ED LCADC-S, ICGC-I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2006
Last updated Oct 21st, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417037334 NPPES
North Carolina Other LICENSE# 1079 CLINICAL ADDICTION SPEC.
North Carolina Other LCA2207 CLINICAL ADDICTION SPEC.
North Carolina MEDICAID 6111892 CLINICAL ADDICTION SPEC.

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