Active NPI
Marvin B Lew, PH.D.
- Cognitive & Behavioral Psychologist
- Weston, FL
National Provider Identifier
1215087622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PY 6957
- Practice address
- 1040 Weston Road
Suite 210
Weston, FL 33326 - Phone
- (954) 349-2777
- Fax
- (954) 349-3440
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PY 6957 | FL | Primary |
Addresses
Primary practice location
1040 Weston Road
Suite 210
Weston, FL 33326
Mailing address
1040 Weston Road
Suite 210
Weston, FL 33326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 5, 2022 through Oct 5, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3089 | MA | MD | Behavioral Analyst |
| PY 6957 | FL | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215087622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 WESTON ROAD",
"address_2": "SUITE 210",
"city": "WESTON",
"state": "FL",
"postal_code": "33326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 WESTON ROAD",
"address_2": "SUITE 210",
"city": "WESTON",
"state": "FL",
"postal_code": "33326",
"telephone_number": "954-349-2777",
"fax_number": "954-349-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEW",
"first_name": "MARVIN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "FL",
"license": "PY 6957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.