Organization
AMANDA LEWIS, MSW, LCSW, LLC
Active
Organization
AMANDA LEWIS, MSW, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROSE LEWIS LCSW (MANAGING MEMBER)
(618) 334-5571
Entity
Organization
Contact information
Practice address
1161 FORTUNE BLVD, SUITE 400, SHILOH, IL 62269-7385
(618) 334-5571
Mailing address
1161 FORTUNE BLVD, SUITE 400, SHILOH, IL 62269-7385
(618) 334-5571
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149.018245
IL
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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