Provider Demographics
NPI:1548947435
Name:LEWIS, JEFFREY BRETT (LPC, CADC-II)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BRETT
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LPC, CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4813
Mailing Address - Country:US
Mailing Address - Phone:912-633-8534
Mailing Address - Fax:
Practice Address - Street 1:800 E 70TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4813
Practice Address - Country:US
Practice Address - Phone:912-633-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional