Provider Demographics
NPI:1548076334
Name:LEWIS, ASHLEY A (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:A
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17240 133RD AVE APT 8E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3926
Mailing Address - Country:US
Mailing Address - Phone:347-458-2828
Mailing Address - Fax:
Practice Address - Street 1:17240 133RD AVE APT 8E
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3926
Practice Address - Country:US
Practice Address - Phone:347-458-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker