Provider Demographics
NPI:1649153958
Name:LEWIS, BARON N (QMHP-CS)
Entity type:Individual
Prefix:
First Name:BARON
Middle Name:N
Last Name:LEWIS
Suffix:
Gender:M
Credentials:QMHP-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W MOCKINGBIRD LN STE 480
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-5062
Mailing Address - Country:US
Mailing Address - Phone:972-489-5552
Mailing Address - Fax:318-557-1559
Practice Address - Street 1:2002 DRIPPING SPRINGS DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5138
Practice Address - Country:US
Practice Address - Phone:972-975-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator