Provider Demographics
NPI:1871982108
Name:LEWELLEN, CAMI (LPC)
Entity type:Individual
Prefix:MRS
First Name:CAMI
Middle Name:
Last Name:LEWELLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAMI
Other - Middle Name:
Other - Last Name:ROWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:624 NW 5
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160
Mailing Address - Country:US
Mailing Address - Phone:405-912-3870
Mailing Address - Fax:405-799-0912
Practice Address - Street 1:624 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3924
Practice Address - Country:US
Practice Address - Phone:405-912-3870
Practice Address - Fax:405-799-0912
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1507101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor