Organization Active NPI

Guardian Allies Collective LLC

  • School Psychologist
  • North Charleston, SC
National Provider Identifier
1124988381
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Legal business name
GUARDIAN ALLIES COLLECTIVE LLC
Practice address
2155 N Park LN Ste 216
North Charleston, SC 29406-9261
Phone
(843) 969-0297
Fax
(854) 258-5167
NPI assigned
Nov 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paula Michelle Lewis, ED.D., LPESNPI 1942067368
Title
Chief Executive Officer
Phone
(904) 472-6050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X Primary

Addresses

Primary practice location

2155 N Park LN Ste 216
North Charleston, SC 29406-9261

Mailing address

6565 Ward Pkwy
Melbourne, FL 32904-3636
Phone (904) 472-6050

Other identifiers 1

IdentifierTypeStateIssuer
LP1071MedicaidSC

National Provider Directory

National Provider Directory

Locations

2155 N Park Ln
Ste 216
North Charleston, SC 29406
Phone (843) 969-0297

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1124988381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 WARD PKWY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043636",
            "telephone_number": "904-472-6050",
            "fax_number": "854-258-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 N PARK LN STE 216",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069261",
            "telephone_number": "843-969-0297",
            "fax_number": "854-258-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ALLIES COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "904-472-6050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D., LPES"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LP1071",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.