Provider Demographics
NPI:1558517698
Name:LEWIS, CARRIE ANN (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:LANDIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:1822 N MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-1350
Mailing Address - Country:US
Mailing Address - Phone:508-674-3334
Mailing Address - Fax:508-674-5855
Practice Address - Street 1:49 STATE RD STE 201
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3322
Practice Address - Country:US
Practice Address - Phone:508-910-2221
Practice Address - Fax:508-910-2214
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00187231H00000X
MAAUD757237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007061097Medicare PIN