Provider Demographics
NPI:1811380512
Name:LEWIS, SHRONICA D
Entity type:Individual
Prefix:
First Name:SHRONICA
Middle Name:D
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 WESTBURY LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-4374
Mailing Address - Country:US
Mailing Address - Phone:346-795-4029
Mailing Address - Fax:
Practice Address - Street 1:6605 CYPRESSWOOD DR STE 175
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7709
Practice Address - Country:US
Practice Address - Phone:713-510-4556
Practice Address - Fax:713-389-5941
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional