Individual
MS. SUSANNA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS, LPCA
Contact information
Practice address
708 S CHESTNUT ST, GASTONIA, NC 28054-4548
(252) 531-7822
Mailing address
703 ROLLERTON RD, APT.106, CHARLOTTE, NC 28205-1057
(252) 531-7822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1688
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
NC
Enumeration date
11/16/2010
Last updated
10/07/2015
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