Donna M Lewis LCSW PLLC
Organization Active NPI Clinical Social Worker · Gautier, MS
NPI 1114595485 · NPPES record last updated Jun 14, 2021
Key facts
- NPI
- 1114595485
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- DONNA M LEWIS LCSW PLLC
- Practice address
- 1713 Old Spanish TRL
Gautier, MS 39553-6027 - Phone
- (228) 218-9825
- Fax
- (228) 282-8578
- NPI assigned
- Jun 14, 2021
- Organization subpart
- No
Authorized official
- Name
- Mrs. Donna M Lewis, LCSW
- Title
- Sole Member
- Phone
- (228) 218-9825
Practitioners 1
-
Donna Maria Lewis, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210708003631 | MS | Part B Supplier - Clinic/Group Practice | 5991107203 |
Receives reassigned benefits from 1 practitioner Practice locations: Gautier, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
1713 Old Spanish TRL
Gautier, MS 39553-6027
Mailing address
1713 Old Spanish TRL
Gautier, MS 39553-6027
Phone (228) 218-9825
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4835868 | Other | CIGNA | |
| 04620559 | Medicaid | MS |
Other names
- Donna M Lewis LCSW PLLC
Other providers in Gautier, MS
- Taylor Elizabeth Dehaven
- Benett Faith Demeritt
- Debra Ann Dionne
- Angela Michelle Dodson
- Robert Walter Donald
- Corey Richaude Dorsey
- Dean Shepard Doty
- Jaiden A Downs
- Todd A Doyle
- Dr. Samuel B. Mayfield
All providers in Gautier, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.