Individual provider Active NPI

Corinne Jill Lewkowicz, PHD

  • Psychologist
  • Columbia, MD
National Provider Identifier
1649770462
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05964 Issued in MD
Practice address
10632 Little Patuxent Pkwy Ste 310
Columbia, MD 21044-6263
Phone
(339) 225-0969
NPI assigned
Feb 19, 2018
Last updated
Feb 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 05964 MD Primary

Addresses

Primary practice location

10632 Little Patuxent Pkwy Ste 310
Columbia, MD 21044-6263

Mailing address

10632 Little Patuxent Pkwy Ste 310
Columbia, MD 21044-6263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 7, 2020 through Apr 7, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05964MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Everbreeze Psychological Services LLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1649770462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 310",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY STE 310",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210446263",
            "telephone_number": "339-225-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWKOWICZ",
        "first_name": "CORINNE",
        "middle_name": "JILL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.