Individual provider Active NPI

Elijah Lewis, MSW, LCSW

  • Clinical Social Worker
  • Coral Gables, FL
National Provider Identifier
1265006407
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22765 Issued in FL
Practice address
475 Biltmore Way Ste 109
Coral Gables, FL 33134-5724
Phone
(415) 424-4266
Fax
(415) 520-6633
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 SW22765 FL Primary

Addresses

Primary practice location

475 Biltmore Way Ste 109
Coral Gables, FL 33134-5724

Mailing address

8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266

Other practice location 1

6147 Christian Way
Orlando, FL 32808-1435
Phone (407) 296-5300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address elewis4@ad.devereux.org
CONNECT URL elewis4@ad.devereux.org

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

LicenseStateTypeSpecialty
SW22765FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Telehealth Services USA Clinical PastSince Dec 8, 2024 Accepting new patients

Organizations & group practices 1

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1265006407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 ESTERS BLVD STE 900",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632233",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BILTMORE WAY STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345724",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6147 Christian Way",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328081435",
            "country_code": "US",
            "telephone_number": "407-296-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIJAH",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elewis4@ad.devereux.org",
            "affiliation": "N",
            "address_1": "6147 Christian Way",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328081435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "elewis4@ad.devereux.org",
            "affiliation": "N",
            "address_1": "6147 Christian Way",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328081435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.