Provider Demographics
NPI:1548993827
Name:LEWIS, ROBERT (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 BROTHERS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6965
Mailing Address - Country:US
Mailing Address - Phone:505-988-6562
Mailing Address - Fax:
Practice Address - Street 1:2209 BROTHERS RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6965
Practice Address - Country:US
Practice Address - Phone:505-988-6562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2024-12631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical