Provider Demographics
NPI:1700511631
Name:LEWIS, AMANDA JO COMBS (LSW)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:JO COMBS
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 READING RD STE A1
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1340
Mailing Address - Country:US
Mailing Address - Phone:513-760-0867
Mailing Address - Fax:
Practice Address - Street 1:757 READING RD STE A1
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1340
Practice Address - Country:US
Practice Address - Phone:513-760-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208501104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.2208501OtherLSW