Active NPI
Olivia Lewis
- School Psychologist
- Frederick, MD
National Provider Identifier
1063238806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 191 S East St
Frederick, MD 21701-5918 - Phone
- (301) 644-5000
- NPI assigned
- Nov 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary | ||
| Behavior Analyst | 103K00000X | LBA907 | MD |
Addresses
Primary practice location
191 S East St
Frederick, MD 21701-5918
Mailing address
191 S East St
Frederick, MD 21701-5918
Phone (240) 586-8814
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LBA907 | MD | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764806400000",
"number": "1063238806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 S EAST ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217015918",
"telephone_number": "240-586-8814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 S EAST ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217015918",
"telephone_number": "301-644-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-26",
"last_updated": "2025-12-04",
"certification_date": "2025-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA907",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.