Basic Information
| Provider Information | |||||||||
| NPI: | 1992874903 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | V | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HARRIS | ||||||||
| OtherFirstName: | SHARON | ||||||||
| OtherMiddleName: | V | ||||||||
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| OtherNameSuffix: | |||||||||
| OtherCredential: | LPC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5648 CHARLOTTE PKWY | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809223411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195748370 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2864 S CIRCLE DR | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809064114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193144260 | ||||||||
| FaxNumber: | 7192646616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3802 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.