Angela D Lewis, LPC

Individual provider Active NPI Professional Counselor · Fredericktown, MO

NPI 1447934278 · NPPES record last updated Jul 16, 2026

Key facts

NPI
1447934278
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2026024291 (MO)
Practice address
600 Sargent Dr
Fredericktown, MO 63645-7526
Phone
(573) 783-4400
Fax
(573) 783-4409
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2023021559MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Tabernacle World Outreach Inc Current
since Jun 18, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2026024291 MO Yes

Addresses

Primary practice location

600 Sargent Dr
Fredericktown, MO 63645-7526

Mailing address

PO Box 25
Fredericktown, MO 63645-0025
Phone (573) 783-4400

Other providers in Fredericktown, MO

All providers in Fredericktown, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.