Provider Demographics
NPI:1366894412
Name:LEWIS, CLAIRE ELIZABETH (LMFT, RPT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT, RPT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:2689 FRANKFORT RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8611
Mailing Address - Country:US
Mailing Address - Phone:859-537-9779
Mailing Address - Fax:502-868-9312
Practice Address - Street 1:2689 FRANKFORT RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8611
Practice Address - Country:US
Practice Address - Phone:859-537-9779
Practice Address - Fax:502-868-9312
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100493900Medicaid