Individual
LEWIS P HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D. LCP
Contact information
Practice address
3114 FLOYD AVE APT A, RICHMOND, VA 23221-2902
(734) 422-9340
(734) 422-9353
Mailing address
12850 FOUNTAIN SQ, DAVISBURG, MI 48350-2552
(248) 634-6303
(248) 634-1746
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810005622
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
750910401
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/08/2009
Last updated
06/21/2022
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