Provider Demographics
NPI:1528827805
Name:LEWIS, ABIGAIL M (MA, LPC, SCL)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MA, LPC, SCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3830
Mailing Address - Country:US
Mailing Address - Phone:248-978-3411
Mailing Address - Fax:
Practice Address - Street 1:2700 MOHAWK LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-3830
Practice Address - Country:US
Practice Address - Phone:248-978-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222475101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor