Scott Avery Lewis, MA, MHT III, CHT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CG60525494 Issued in WA

Practice address

4526 Federal Ave
Everett, WA 98203-2132

Phone

(425) 349-6200

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Evergreen Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Mount Vernon, WA
  • NPI 1023515400
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1821569963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032132",
            "telephone_number": "425-349-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SCOTT",
        "middle_name": "AVERY",
        "credential": "MA, MHT III, CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "HP60781328",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60917941",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60525494",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CG60525494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Samuel Lewis
• Ankhasia Lewis
• Gale Walker Lewis, MD
• Glenda Mae Lewis VII, LMT
• Jane Elizabeth Lewis, M.D.
• Sheri Lynn Lewis
• Stefani Lewis, LSWAIC
• Stephanie Lewis
• Tanica Lewis
• Valerie J Lewis, B.A.

• Behavior Technician in Everett, WA
• Providers in Everett, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.