Active NPI
Johnny Lewis, CDP
- Addiction (Substance Use Disorder) Counselor
- Tacoma, WA
National Provider Identifier
1558536136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CPOOOO2988
- Practice address
- 2209 E 32ND St
Tacoma, WA 98404-4922 - Phone
- (253) 593-0291
- Fax
- (253) 441-2710
- NPI assigned
- Apr 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CPOOOO2988 | WA | Primary |
Addresses
Primary practice location
2209 E 32ND St
Tacoma, WA 98404-4922
Mailing address
2209 E 32ND St
Tacoma, WA 98404-4922
Phone (253) 593-0291
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 |
|---|---|---|---|
| CPOOOO2988 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209340800000",
"number": "1558536136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2209 E 32ND ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984044922",
"telephone_number": "253-593-0291",
"fax_number": "253-441-2710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2209 E 32ND ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984044922",
"telephone_number": "253-593-0291",
"fax_number": "253-441-2710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JOHNNY",
"name_prefix": "Mr.",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CPOOOO2988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.