Organization
LAKE MARTIN FAMILY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN C. LEWIS LMFT, LCSW (MEMBER/OWNER)
(256) 625-9514
Entity
Organization
Contact information
Practice address
393 GREEN ST, ALEXANDER CITY, AL 35010-1407
(256) 625-9514
(256) 825-6418
Mailing address
PO BOX 911, ALEXANDER CITY, AL 35011-0911
(256) 625-9514
(256) 825-6418
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2121C
AL
106H00000X
Marriage & Family Therapist
L 299
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121C
STATE OF ALABAMA BOARD OF SOCIAL WORK EXMAINERS
AL
01
—
L 299
ALABAMA BOARD OF EXAMINERS IN MARRIAGE & FAMILY THERAPY
AL
Enumeration date
09/16/2008
Last updated
09/16/2008
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