Provider Demographics
NPI:1447364161
Name:LEWIS, BETTY JANE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BETTY JANE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PERRYRIDGE ROAD
Mailing Address - Street 2:GREENWICH HOSPITAL OUTPATIENT BEHAVIORAL HEALTH
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830
Mailing Address - Country:US
Mailing Address - Phone:203-863-3307
Mailing Address - Fax:203-863-4690
Practice Address - Street 1:5 PERRYRIDGE ROAD
Practice Address - Street 2:GREENWICH HOSPITAL OUTPATIENT BEHAVIORAL HEALTH
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830
Practice Address - Country:US
Practice Address - Phone:203-863-3316
Practice Address - Fax:203-863-4690
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000223104100000X
NYR0212211104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker