Provider Demographics
NPI:1629467311
Name:LEWIS, ELIZABETH (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WINTHROP STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607
Mailing Address - Country:US
Mailing Address - Phone:315-405-1053
Mailing Address - Fax:
Practice Address - Street 1:36 WINTHROP STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607
Practice Address - Country:US
Practice Address - Phone:315-405-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-18
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLMHC014767101YM0800X
CO101YM0800X
COLPC0014948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health