Active NPI
Marcella A Lewis, LCSW
- Clinical Social Worker
- Hernando, MS
National Provider Identifier
1184714982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C7256
- Practice address
- 2375 Memphis St
Suite 208
Hernando, MS 38632-1756 - Phone
- (901) 230-0622
- Fax
- (662) 449-0422
- NPI assigned
- Oct 13, 2006
- Last updated
- Oct 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00688 | TN | |
| Clinical Social Worker | 1041C0700X | C7256 | MS | Primary |
Addresses
Primary practice location
2375 Memphis St
Suite 208
Hernando, MS 38632-1756
Mailing address
2375 Memphis St
Suite 208
Hernando, MS 38632-1756
Phone (901) 230-0622
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00688 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225324800000",
"number": "1184714982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2375 MEMPHIS ST",
"address_2": "SUITE 208",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386321756",
"telephone_number": "901-230-0622",
"fax_number": "662-449-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 MEMPHIS ST",
"address_2": "SUITE 208",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386321756",
"telephone_number": "901-230-0622",
"fax_number": "662-449-0422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MARCELLA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2008-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "00688",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MS",
"license": "C7256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hernando, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.