Provider Demographics
NPI:1427455690
Name:LEWIS, TAMICKA I (HHA)
Entity type:Individual
Prefix:
First Name:TAMICKA
Middle Name:
Last Name:LEWIS
Suffix:I
Gender:F
Credentials:HHA
Other - Prefix:MISS
Other - First Name:TAMICKA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 BLUERIDGE AVE
Mailing Address - Street 2:301
Mailing Address - City:SILVER SPRING
Mailing Address - State:DC
Mailing Address - Zip Code:20019
Mailing Address - Country:US
Mailing Address - Phone:202-292-8592
Mailing Address - Fax:301-933-2007
Practice Address - Street 1:2401 BLUERIDGE AVE SILVERSPRING
Practice Address - Street 2:SUITE 301
Practice Address - City:SILVER SPRING
Practice Address - State:DC
Practice Address - Zip Code:20019-2001
Practice Address - Country:US
Practice Address - Phone:301-949-0466
Practice Address - Fax:301-933-2007
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2002659103K00000X, 207K00000X
DCHHA6659374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology