Provider Demographics
NPI:1760986541
Name:LEWIN, KATHRYN EMILY (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:EMILY
Last Name:LEWIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4387
Mailing Address - Country:US
Mailing Address - Phone:201-274-4411
Mailing Address - Fax:
Practice Address - Street 1:1608 QUAIL RUN RD
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4387
Practice Address - Country:US
Practice Address - Phone:201-274-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX612171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator