Provider Demographics
NPI:1336853746
Name:MCKENIE-LEWIS, MELISSA ALMOND (LAPC)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ALMOND
Last Name:MCKENIE-LEWIS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 FAIRBROOKE PATH
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-4022
Mailing Address - Country:US
Mailing Address - Phone:770-572-1341
Mailing Address - Fax:
Practice Address - Street 1:7910 MALL RING RD STE 200
Practice Address - Street 2:
Practice Address - City:STONECREST
Practice Address - State:GA
Practice Address - Zip Code:30038-2698
Practice Address - Country:US
Practice Address - Phone:404-585-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006762101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health