Individual ProviderMichelle LewisSocial WorkerBehavioral Health & Social Service ProvidersPractice Address7105 S. Highland Dr., Ste 303, Salt Lake City, UT 84121(801) 907-1391PECOS EnrollmentBased on the most recent information from CMS, provider Michelle Lewis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558676338Provider TypeIndividualFull NameLewis, MichelleCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date8/17/2010Last Updated8/17/2010Contact InformationPractice LocationPractice Address7105 S. Highland Dr., Ste 303, Salt Lake City, UT 84121Phone(801) 907-1391FaxUnlisted FaxMailing LocationMailing Address7105 Highland Dr, Ste 303, Salt Lake City, UT 84121-3753Phone(801) 907-1391FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense6198245-3501Utah