Provider Demographics
NPI:1760532196
Name:LEWIS, ARLESS RICHEY (LPC)
Entity Type:Individual
Prefix:MR
First Name:ARLESS
Middle Name:RICHEY
Last Name:LEWIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1101
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-1101
Mailing Address - Country:US
Mailing Address - Phone:770-826-9277
Mailing Address - Fax:855-728-4997
Practice Address - Street 1:211 PEEKSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3138
Practice Address - Country:US
Practice Address - Phone:770-826-9277
Practice Address - Fax:855-728-4997
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3171101YP2500X
GA005591101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional