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Individual
LOGAN LEWIS
Active
Individual
LOGAN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
105136-1
NY
1041C0700X
Clinical Social Worker
Primary
096156
NY
106H00000X
Marriage & Family Therapist
001662
NY
Other
Enumeration date
12/10/2018
Last updated
11/28/2023
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