Provider Demographics
NPI:1912797473
Name:LEWIS, ROXANNE COLLETTE (CPS-MH)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:COLLETTE
Last Name:LEWIS
Suffix:
Gender:
Credentials:CPS-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 18TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1504
Mailing Address - Country:US
Mailing Address - Phone:706-243-9521
Mailing Address - Fax:
Practice Address - Street 1:1000 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1504
Practice Address - Country:US
Practice Address - Phone:706-243-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist