Provider Demographics
NPI:1871969550
Name:LEWIS, AHSHA (MS)
Entity type:Individual
Prefix:
First Name:AHSHA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 E MOHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-4550
Mailing Address - Country:US
Mailing Address - Phone:813-210-4049
Mailing Address - Fax:
Practice Address - Street 1:3604 E MOHAWK AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4550
Practice Address - Country:US
Practice Address - Phone:813-210-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health