Individual
TRUDI SIEGLINDE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
129 E MAIN ST, MOREHEAD, KY 40351-1657
(606) 783-1010
(606) 783-1010
Mailing address
129 EAST MAIN STREET, MOREHEAD, KY 40351
(606) 783-1010
(606) 783-1010
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2195
KY
1041C0700X
Clinical Social Worker
Primary
3045
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350189
ANTHEM BCBS
—
01
—
1059550
WV WORKERS COMP
WV
05
—
30310026
—
KY
01
—
610661987006
TRICARE
—
Enumeration date
08/08/2006
Last updated
01/21/2009
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