Individual
MS. MICHELE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED LCADC-S, ICGC-I
Contact information
Practice address
640 BARTLETT AVENUE, LOWER LEVEL, BALTIMORE, MD 21218-5412
(443) 613-0506
Mailing address
640 BARTLETT AVENUE, LOWER LEVEL, BALTIMORE, MD 21218-5412
(443) 613-0506
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1079
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA2207
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111892
—
NC
01
—
LCA2207
LCADC
MD
01
—
LICENSE# 1079
CLINICAL ADDICTION SPEC.
NC
Enumeration date
10/16/2006
Last updated
10/21/2019
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