Provider Demographics
NPI:1932863594
Name:LEWIS, MAUREEN E (LMSW)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MALTESE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2141
Mailing Address - Country:US
Mailing Address - Phone:845-342-4774
Mailing Address - Fax:
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2536
Practice Address - Country:US
Practice Address - Phone:845-281-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113819104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113819OtherNYS LICENSE
NY02997780Medicaid