Provider Demographics
NPI:1154034767
Name:LEWIS, CASSIDY ANNE
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:ANNE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-5370
Mailing Address - Country:US
Mailing Address - Phone:413-561-0060
Mailing Address - Fax:
Practice Address - Street 1:1236 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5370
Practice Address - Country:US
Practice Address - Phone:413-561-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool