| Jaclyn Lewis-croswell, Psy D Pllc | |
|
13357 N 56th St Tampa FL 33617-1161 | |
| (813) 679-6300 | |
| Not Available |
| Full Name | Jaclyn Lewis-croswell, Psy D Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 13357 N 56th St, Tampa, Florida |
| Authorized Official Name and Position | Jaclyn Lee Lewis-croswell (CEO) |
| Authorized Official Contact | 8136796300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaclyn Lewis-croswell, Psy D Pllc 2307 Nesslewood Dr Wesley Chapel FL 33543-5119 Ph: (813) 679-6300 | Jaclyn Lewis-croswell, Psy D Pllc 13357 N 56th St Tampa FL 33617-1161 Ph: (813) 679-6300 |
| NPI Number | 1609530831 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/12/2022 |
| Medicare PECOS PAC ID | 6103218599 |
|---|---|
| Medicare Enrollment ID | O20220114001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609530831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jaclyn L Lewis-croswell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649418948 PECOS PAC ID: 7214161082 Enrollment ID: I20131010000029 |
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