Individual
KASSIDI LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 E NORTH ST, MAGNOLIA, AR 71753-3120
(870) 234-0739
Mailing address
1600 ALDERSGATE RD STE 200, LITTLE ROCK, AR 72205-6676
(501) 661-0720
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
7623
LA
101YM0800X
Mental Health Counselor
A1812166
AR
101YP2500X
Professional Counselor
Primary
P2603002
AR
Other
Enumeration date
10/30/2018
Last updated
05/04/2026
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