Provider Demographics
NPI:1427533785
Name:LEWIS, KRISTEN ALEXANDRA
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ALEXANDRA
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 1:519 W SAN RAFAEL ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1037
Mailing Address - Country:US
Mailing Address - Phone:571-422-7043
Mailing Address - Fax:
Practice Address - Street 1:519 W SAN RAFAEL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1037
Practice Address - Country:US
Practice Address - Phone:571-422-7043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical