Provider Demographics
NPI:1659150134
Name:LEWIS, RACHAEL (PRE-LICENSED LAPC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PRE-LICENSED LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 VICTORIA WALK SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-1101
Mailing Address - Country:US
Mailing Address - Phone:404-290-9120
Mailing Address - Fax:
Practice Address - Street 1:2727 PACES FERRY RD SE STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4053
Practice Address - Country:US
Practice Address - Phone:404-290-9120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health