Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | 39001745A | IN |
Y | 103G00000X | Clinical Psychologist | 20042541A | IN |
Y | 103TC0700X | Clinical Psychologist | 20042541A | IN |
N | 103TC1900X | Counseling Psychologist |
NPI | 1093786816 |
---|---|
Provider Name | Dr. Anne P Lewis |
First Address | Fishers, IN 46037-3839 |
Second Address | Fishers, IN 46037-3839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 30/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201042020 | (05) | IN |