Individual
KIMBERLY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
140 W MAIN ST STE E, WINNECONNE, WI 54986-9409
(920) 460-9814
Mailing address
2400 S. KENSINGTON DR. STE. 400, APPLETON, WI 54915-4186
(920) 659-0634
(920) 239-6003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14548-132
WI
104100000X
Social Worker
Primary
7377-123
WI
1041C0700X
Clinical Social Worker
7377
WI
1041C0700X
Clinical Social Worker
7377-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100194005
FORWARD HEALTH
—
05
—
100194005
—
WI
05
—
1972942175
—
WI
Enumeration date
06/20/2013
Last updated
10/20/2022
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