Provider Demographics
NPI:1427640416
Name:LEWERK, MARTIN GONZALES (LCSW)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:GONZALES
Last Name:LEWERK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OSBORNE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2513
Mailing Address - Country:US
Mailing Address - Phone:860-383-6849
Mailing Address - Fax:
Practice Address - Street 1:12 OSBORNE ST APT 1
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2513
Practice Address - Country:US
Practice Address - Phone:860-383-6849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA228031OtherASWB