Mallory Amanda Lewis, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

139645 Issued in CA

Practice address

2560 W Shaw LN Ste 104
Fresno, CA 93711-2777

Phone

(559) 443-4800

Fax

(559) 443-4800

NPI assigned

Mar 12, 2020

Last updated

Jan 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dwight W Sievert MD Inc

  • Psychiatry Physician
  • Fresno, CA
  • NPI 1972509214
  NPD
• Fresno County Superintendent of Schools

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1235624768
  NPD
• Fresno County Superintendent of Schools

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1467042408
  NPD
• Olive Leaf Family Therapy, Inc

  • Marriage & Family Therapist
  • Fresno, CA
  • NPI 1447816079
  NPD
• Fresno County Superintendent of Schools

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Selma, CA
  • NPI 1114549110
  NPD (past)

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1417583279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800",
            "fax_number": "559-443-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 W SHAW LN STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937112777",
            "telephone_number": "559-443-4800",
            "fax_number": "559-443-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 High St Ste E",
            "address_purpose": "LOCATION",
            "city": "Selma",
            "state": "CA",
            "postal_code": "936623518",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4939 E Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271523",
            "country_code": "US",
            "telephone_number": "559-443-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MALLORY",
        "middle_name": "AMANDA",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "139645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BBS REGISTRATION",
            "identifier": "118150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Lewis
• Faith Lewis
• Kaia Renay Lewis
• Laniah Lewis
• Latoya Lewis
• Mary Lewis
• Maurice David Lewis Sr.
• Miranda M Lewis, M.D.
• Nina Lewis, N.D.
• Patrick Lewis, MFT TRAINEE

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.