Individual
MICKEY L LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT/CADC
Contact information
Practice address
215 BLUEGRASS RD, UNIT C, FRANKLIN, KY 42134-2459
(270) 253-3722
(270) 253-3768
Mailing address
215C BLUEGRASS ROAD, FRANKLIN, KY 42134
(270) 253-3722
(270) 253-3768
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0060
KY
106H00000X
Marriage & Family Therapist
Primary
0348
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
07/21/2006
Last updated
10/28/2013
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