Provider Demographics
NPI:1750891420
Name:LEWIS, JAMESA A E (LCPC)
Entity type:Individual
Prefix:
First Name:JAMESA
Middle Name:A E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14733 4TH ST UNIT 288
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4085
Mailing Address - Country:US
Mailing Address - Phone:240-565-3639
Mailing Address - Fax:
Practice Address - Street 1:14201 LAUREL PARK DR STE 226
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5230
Practice Address - Country:US
Practice Address - Phone:240-583-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-06
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8141101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional