# DONNA M LEWIS LCSW PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Donna M Lewis LCSW PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114595485
- **Authorized official:** MRS. DONNA M LEWIS LCSW (SOLE MEMBER)
- **Authorized official phone:** (228) 218-9825

## Contact information

- **Practice address:** 1713 OLD SPANISH TRL, GAUTIER, MS 39553-6027
- **Practice address phone:** (228) 218-9825
- **Practice address fax:** (228) 282-8578
- **Mailing address:** 1713 OLD SPANISH TRL, GAUTIER, MS 39553-6027
- **Mailing address phone:** (228) 218-9825
- **Mailing address fax:** (228) 282-8578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2021
- **Last updated:** 06/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04620559 | — | MS |
| 01 | — | 4835868 | CIGNA | — |