Provider Demographics
NPI:1811455181
Name:LEWIS, ASHLEY MONEE (QMHP-A)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MONEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:QMHP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9521 TURF CLUB LN APT 1018
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5320
Mailing Address - Country:US
Mailing Address - Phone:804-334-2755
Mailing Address - Fax:804-352-2105
Practice Address - Street 1:9521 TURF CLUB LN APT 1018
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-5320
Practice Address - Country:US
Practice Address - Phone:804-334-2755
Practice Address - Fax:804-352-2105
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty