Provider Demographics
NPI:1730825191
Name:LEWIS, NANCY ANN (LCSWA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 SADE ROCK CT
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-4757
Mailing Address - Country:US
Mailing Address - Phone:919-439-9809
Mailing Address - Fax:
Practice Address - Street 1:901 N WINSTEAD AVE STE 260
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8757
Practice Address - Country:US
Practice Address - Phone:252-210-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0199621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical