Individual
MR. SHELLY MARK LEWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
649 HARKLE RD STE E, SANTA FE, NM 87505-4765
(505) 955-9454
(505) 216-9067
Mailing address
PO BOX 6880, SANTA FE, NM 87502-6880
(505) 216-0332
(505) 982-0279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2024-1008
NM
Other
Enumeration date
07/01/2024
Last updated
06/18/2025
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