Provider Demographics
NPI:1932250974
Name:LEWIS, DONNA H (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:H
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4143 COLUMBIA RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-5404
Mailing Address - Country:US
Mailing Address - Phone:706-651-1299
Mailing Address - Fax:
Practice Address - Street 1:4143 COLUMBIA RD
Practice Address - Street 2:SUITE D
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-5404
Practice Address - Country:US
Practice Address - Phone:706-651-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0016791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical