Active NPI
Tawanna Lewis, LPC
- Professional Counselor
- Marietta, GA
National Provider Identifier
1467862136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC007590
- Practice address
- 707 Whitlock Ave SW
Suite H11
Marietta, GA 30064-3000 - Phone
- (770) 853-7074
- Fax
- (678) 398-9065
- NPI assigned
- May 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC007590 | GA | Primary |
Addresses
Primary practice location
707 Whitlock Ave SW
Suite H11
Marietta, GA 30064-3000
Mailing address
PO Box 1951
Mableton, GA 30126
Phone (770) 853-7074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003175726A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC007590 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1467862136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1951",
"city": "MABLETON",
"state": "GA",
"postal_code": "30126",
"telephone_number": "770-853-7074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 WHITLOCK AVE SW",
"address_2": "SUITE H11",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300643000",
"telephone_number": "770-853-7074",
"fax_number": "678-398-9065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "TAWANNA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-05",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC007590",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003175726A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.