Individual provider Active NPI

Zen Jordan Lewis, PHD, LMHC, LPCC

  • Mental Health Counselor
  • Burbank, CA
National Provider Identifier
1003904038
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH-9760 Issued in FL
Practice address
213 W Alameda Ave Ste 103
Burbank, CA 91502-3027
Phone
(833) 333-7936
Fax
(561) 620-2972
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH-9760 FL Primary

Addresses

Primary practice location

213 W Alameda Ave Ste 103
Burbank, CA 91502-3027

Mailing address

398 Camino Gardens Blvd
Suite 100
Boca Raton, FL 33432-5827
Phone (954) 399-2093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH-9760FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1003904038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 CAMINO GARDENS BLVD",
            "address_2": "SUITE 100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334325827",
            "telephone_number": "954-399-2093",
            "fax_number": "561-620-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W ALAMEDA AVE STE 103",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023027",
            "telephone_number": "833-333-7936",
            "fax_number": "561-620-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ZEN",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "PHD, LMHC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-9760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.