Provider Demographics
NPI:1487931135
Name:LEWIS, CINDY A (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:A
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 ILLINOIS AVE N
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2541
Mailing Address - Country:US
Mailing Address - Phone:419-989-0412
Mailing Address - Fax:
Practice Address - Street 1:187 ILLINOIS AVE N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2541
Practice Address - Country:US
Practice Address - Phone:419-989-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0009924 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical