Provider Demographics
NPI:1366052763
Name:TEMPLE, LEWIS H III (MDIV)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:H
Last Name:TEMPLE
Suffix:III
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1923
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37744-1923
Mailing Address - Country:US
Mailing Address - Phone:423-207-2338
Mailing Address - Fax:423-609-7164
Practice Address - Street 1:59 PARK AVE W
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3610
Practice Address - Country:US
Practice Address - Phone:404-277-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral