Active NPI
Kurt Jan Lewis, LLMSW
- Behavior Technician
- Farmington Hills, MI
National Provider Identifier
1619304862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 6801096167
- Practice address
- 2777 Inkster Road
Suite 100
Farmington Hills, MI 48334-3418 - Phone
- (855) 772-8847
- Fax
- (269) 698-2651
- NPI assigned
- Oct 2, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801096167 | MI | |
| Behavior Technician | 106S00000X | 6801096167 | MI | Primary |
Addresses
Primary practice location
2777 Inkster Road
Suite 100
Farmington Hills, MI 48334-3418
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (269) 968-2811
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 |
|---|---|---|---|
| 6801096167 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1619304862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345312",
"telephone_number": "269-968-2811",
"fax_number": "269-968-2651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2777 INKSTER ROAD",
"address_2": "SUITE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483343418",
"telephone_number": "855-772-8847",
"fax_number": "269-698-2651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "KURT",
"middle_name": "JAN",
"name_prefix": "Mr.",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-02",
"last_updated": "2022-05-05",
"certification_date": "2022-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801096167",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "6801096167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.