Provider Demographics
NPI:1306890769
Name:LEWIS, JANE HART (MS, LPC, LPCS)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:HART
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS, LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5519
Mailing Address - Country:US
Mailing Address - Phone:843-679-9200
Mailing Address - Fax:843-665-8676
Practice Address - Street 1:503 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5519
Practice Address - Country:US
Practice Address - Phone:843-679-9200
Practice Address - Fax:843-665-8676
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional