Active NPI
Michele Lewis, M.ED LCADC-S, ICGC-I
- Addiction (Substance Use Disorder) Counselor
- Baltimore, MD
National Provider Identifier
1417037334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCA2207
- Practice address
- 640 Bartlett Avenue
Lower Level
Baltimore, MD 21218-5412 - Phone
- (443) 613-0506
- NPI assigned
- Oct 16, 2006
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1079 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCA2207 | MD | Primary |
Addresses
Primary practice location
640 Bartlett Avenue
Lower Level
Baltimore, MD 21218-5412
Mailing address
640 Bartlett Avenue
Lower Level
Baltimore, MD 21218-5412
Phone (443) 613-0506
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LICENSE# 1079 | Other | NC | CLINICAL ADDICTION SPEC. |
| LCA2207 | Other | MD | LCADC |
| 6111892 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCA2207 | MD | MD | Addiction (Substance Use Disorder) Counselor |
| 1079 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1417037334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 BARTLETT AVENUE",
"address_2": "LOWER LEVEL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212185412",
"telephone_number": "443-613-0506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 BARTLETT AVENUE",
"address_2": "LOWER LEVEL",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212185412",
"telephone_number": "443-613-0506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MICHELE",
"name_prefix": "Ms.",
"credential": "M.ED LCADC-S, ICGC-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1079",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "LCA2207",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL ADDICTION SPEC.",
"identifier": "LICENSE# 1079",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCADC",
"identifier": "LCA2207",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6111892",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.