| Lewis Family Wellness Center Llc | |
|
8525 Edinbrook Xing Ste 15 Brooklyn Park MN 55443-1967 | |
| (763) 691-9002 | |
| (763) 226-2390 |
| Full Name | Lewis Family Wellness Center Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 8525 Edinbrook Xing Ste 15, Brooklyn Park, Minnesota |
| Authorized Official Name and Position | Cerise Dione Lewis (OWNER/LMFT) |
| Authorized Official Contact | 7636919002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewis Family Wellness Center Llc 8525 Edinbrook Xing Ste 15 Brooklyn Park MN 55443-1967 Ph: (763) 691-9002 | Lewis Family Wellness Center Llc 8525 Edinbrook Xing Ste 15 Brooklyn Park MN 55443-1967 Ph: (763) 691-9002 |
| NPI Number | 1881289221 |
|---|---|
| Provider Enumeration Date | 03/08/2021 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/03/2023 |
| Medicare PECOS PAC ID | 4486007721 |
|---|---|
| Medicare Enrollment ID | O20240202000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881289221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Cerise Dione Lewis |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912592353 PECOS PAC ID: 6305844499 Enrollment ID: I20240202000165 |
| Provider Name | Tia Vang |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639872294 PECOS PAC ID: 1850739533 Enrollment ID: I20240401000377 |
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