Individual provider · Type 1 NPI

Kellen Lewis Sr.

Mental Health Counselor · Fort Wayne, IN

NPI number 1124712484 Active

Practice location

6202 Constitution Dr
Fort Wayne, IN 46804-1583

Call (260) 515-0522 Map

Mailing address

9712 Serpentine Cv
Fort Wayne, IN 46804-5238

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X88001951A (IN)

Mental Health Counselor: Definition to come...

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About NPI 1124712484

Kellen Lewis Sr.'s National Provider Identifier is 1124712484, issued on Jun 7, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Wayne, IN. The record was last updated on Jun 7, 2023.