Individual provider Active NPI

Andre L Lewis, L.C.S.W

  • Clinical Social Worker
  • Pine Bluff, AR
National Provider Identifier
1124048871
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2170-C Issued in AR
Practice address
2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone
(870) 534-1834
Fax
(870) 534-5798
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2170-C AR Primary

Addresses

Primary practice location

2500 Rike Dr
Pine Bluff, AR 71603-3937

Mailing address

PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534

Other practice location 1

1308 W 5th Ave
Crossett, AR 71635-2500
Phone (870) 364-6471 ext. 1307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081126000562 AR Practitioner - Clinical Social Worker 6709882160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Arkansas Behavioral Healthcare System IncGroup PAC ID 0042292674, 16 clinicians

Practice addresses (Care Compare)

2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone (870) 534-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2170-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Behavioral Healthcare System Inc CurrentSince Sep 18, 2023 Accepting new patients

Locations

2500 Rike Dr
Pine Bluff, AR 71603
Phone (870) 534-1834

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1124048871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720060497",
            "telephone_number": "870-347-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 RIKE DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716033937",
            "telephone_number": "870-534-1834",
            "fax_number": "870-534-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 W 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Crossett",
            "state": "AR",
            "postal_code": "716352500",
            "country_code": "US",
            "telephone_number": "870-364-6471 x1307",
            "fax_number": "870-364-9753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ANDRE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2170-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.