Individual
ELAINE LEWIS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6929 MARINER DR, RACINE, WI 53406-3938
(414) 571-9484
(414) 571-9648
Mailing address
2713 N MAIN ST, RACINE, WI 53402-4249
(414) 571-9484
(414) 571-9648
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39784900
—
WI
Enumeration date
04/10/2007
Last updated
07/08/2007
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