Individual provider Active NPI

Michael P Lewis, MA

  • Professional Counselor
  • Berea, KY
National Provider Identifier
1598815565
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1487 Issued in KY
Practice address
1315 Gabbardtown Rd
Berea, KY 40403-9278
Phone
(859) 253-1686
Fax
(859) 254-2743
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1487 KY Primary

Addresses

Primary practice location

1315 Gabbardtown Rd
Berea, KY 40403-9278

Mailing address

1351 Newtown Pike
Lexington, KY 40511-1217
Phone (859) 253-1686

Other identifiers 1

IdentifierTypeStateIssuer
30615058MedicaidKY

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1487KYMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1598815565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 NEWTOWN PIKE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111217",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 GABBARDTOWN RD",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404039278",
            "telephone_number": "859-253-1686",
            "fax_number": "859-254-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "1487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30615058",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.