Jeffrey Robert Lewis, CDAC I SUD COUNSELOR

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CI30160720 Issued in CA

Practice address

2107 1St St
Eureka, CA 95501-0840

Phone

(707) 476-4100

NPI assigned

Dec 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1407514938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 1ST ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010840",
            "telephone_number": "707-273-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 1ST ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010840",
            "telephone_number": "707-476-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "credential": "CDAC I SUD COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "CI30160720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Dyani Levy-Boyd, M.S.W.
• Judith Levy
• Julie Ann Schmieder Levy
• Shao-Lan Lew-Smith
• Gordon Robert Lewis, DDS
• Kristina Lewis
• Lori Anne Lewis, R.N., P.H.N., C.S.N.
• Manuel Diaz Lewis, DO
• Rachel Lewis
• Dominick Lee Leyva, CM II, QMHA II

• Addiction (Substance Use Disorder) Counselor in Eureka, CA
• Providers in Eureka, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.