Pamela J Lewis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH10100 Issued in FL

Practice address

1724 Village Way
Suite a
Orange Park, FL 32073-5264

Phone

(904) 269-0886

Fax

(904) 269-0499

NPI assigned

Jun 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Pamela Waters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1276300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276300800000",
    "number": "1356662449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MYRTLE AVE",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320433026",
            "telephone_number": "904-284-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 VILLAGE WAY",
            "address_2": "SUITE A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735264",
            "telephone_number": "904-269-0886",
            "fax_number": "904-269-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "PAMELA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-12",
        "last_updated": "2010-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10100",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "WATERS",
            "prefix": "MRS.",
            "credential": "M.A., L.P.C., M.H.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lets Talk Openly LLC
• Dasia A Levy
• Belinda Lewis
• Gary William Lewis, PT
• Katherine Morgan Lewis
• Stephanie Tramaine Lewis, COTA
• Eniola O Leyimu, PHARM.D
• Marilyn Leyva Fernandez, RDH
• Licini Inc
• Kerri S. Licini, MA, MAED., BCBA

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2010; 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.