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Contact Information

OMETHA O LEWIS JACK, PHD
2918 MINNESOTA AVE SE
WASHINGTON, DC20019-1127
 Phone: 202-629-2964
 Fax: 877-735-1149
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for OMETHA O LEWIS JACK · (Female)

NPI # 1851736144
Status Active
Credentials PHD
Entity Individual
Enumeration date 05/01/2013
Last updated 05/01/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • DC License # PSY1835
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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