Individual
NICOLE BASHAN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 W 98TH AVE, CROWN POINT, IN 46307
(219) 789-9185
Mailing address
1325 W 98TH AVE, CROWN POINT, IN 46307-2465
(219) 789-9185
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000389A
IN
101YP2500X
Professional Counselor
93611
TX
Other
Enumeration date
05/08/2017
Last updated
12/20/2024
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