Individual
KRYSTAL LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCDC, MAC, SAP
Contact information
Practice address
1001 PEWTER CT, MADISON, TN 37115-5906
(931) 255-2418
Mailing address
1001 PEWTER CT, MADISON, TN 37115-5906
(931) 255-2418
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
78459
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
12503
TX
101YM0800X
Mental Health Counselor
78459
TX
101YP2500X
Professional Counselor
Primary
6314
TN
101YP2500X
Professional Counselor
78459
TX
Other
Enumeration date
05/21/2014
Last updated
01/16/2024
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