Individual provider Active NPI

Dwyana Renee Smithen-Lewis, LPC-R

  • Professional Counselor
  • Richmond, VA
National Provider Identifier
1891458089
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0704014278 Issued in VA
Practice address
4508 S Laburnum Ave Ste 101
Richmond, VA 23231-2476
Phone
(804) 762-0610
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 0704014278 VA Primary

Addresses

Primary practice location

4508 S Laburnum Ave Ste 101
Richmond, VA 23231-2476

Mailing address

4508 S Laburnum Ave
Richmond, VA 23231-2476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905001288 DC Practitioner - Mental Health Counselor 7618417635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0704014278VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Jul 23, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1891458089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 S LABURNUM AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232312476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 S LABURNUM AVE STE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232312476",
            "telephone_number": "804-762-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHEN-LEWIS",
        "first_name": "DWYANA",
        "middle_name": "RENEE",
        "credential": "LPC-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0704014278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.