Individual
CEYONNA CANTRELL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, RESIDENT
Contact information
Practice address
8280 WILLOW OAKS CORPORATE DR STE 600, FAIRFAX, VA 22031-4516
(415) 424-4266
(415) 520-6633
Mailing address
8300 ESTERS BLVD STE 900, IRVING, TX 75063-2233
(415) 424-4266
(415) 520-6633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0704011442
VA
101YP2500X
Professional Counselor
LC13382
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017533260001
—
VA
Enumeration date
07/09/2021
Last updated
07/26/2023
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