Provider Demographics
NPI:1962982793
Name:LEWIS, LEXUS CECILIA (LISW-CP)
Entity type:Individual
Prefix:
First Name:LEXUS
Middle Name:CECILIA
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-9422
Mailing Address - Country:US
Mailing Address - Phone:803-293-8780
Mailing Address - Fax:803-293-8780
Practice Address - Street 1:607 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-9422
Practice Address - Country:US
Practice Address - Phone:803-293-8780
Practice Address - Fax:803-293-8780
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC173531041C0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical