Provider Demographics
NPI:1306620083
Name:LEWIS, VEDA (CADC)
Entity type:Individual
Prefix:MRS
First Name:VEDA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13289 SPIVEYS CORNER HWY
Mailing Address - Street 2:
Mailing Address - City:ROSEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28382-7405
Mailing Address - Country:US
Mailing Address - Phone:910-627-2410
Mailing Address - Fax:
Practice Address - Street 1:13289 SPIVEYS CORNER HWY
Practice Address - Street 2:
Practice Address - City:ROSEBORO
Practice Address - State:NC
Practice Address - Zip Code:28382-7405
Practice Address - Country:US
Practice Address - Phone:910-627-2410
Practice Address - Fax:910-564-2980
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)