Provider Demographics
NPI:1063139848
Name:LEWIS, NKRUMAH D'ANGELO (LCSWA)
Entity type:Individual
Prefix:DR
First Name:NKRUMAH
Middle Name:D'ANGELO
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 PALERMO TRL
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9537
Mailing Address - Country:US
Mailing Address - Phone:336-457-8777
Mailing Address - Fax:
Practice Address - Street 1:5510 PALERMO TRL
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-9537
Practice Address - Country:US
Practice Address - Phone:336-457-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0184171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical