Provider Information for 1235574633
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EVA LEWIS SUPEL LCMHC LCAS
Other Names:Other Name:EVA LEWIS SUPELSex: Female
NPI: 1235574633
Last Updated: 2025-01-30
Certification Date: 2025-01-30
Certification Date: 2025-01-30
Details
| Name | Value | ||||||||||||||||
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| NPI | 1235574633 | ||||||||||||||||
| Enumeration Date | 2013-04-30 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 108 CARVER DRIVE SNOW HILL, NC 28580-1302 United States Phone: 336-312-3818 | Fax:336-450-4358 | ||||||||||||||||
| Primary Practice Address | 208 N GREENE ST SNOW HILL, NC 28580-1410 United States Phone: 336-275-7973 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 820 MARK ST 108 N. FRANKLIN STREET 1458 LONDON DR | ||||||||||||||||
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