Provider Demographics
NPI:1255828539
Name:LEWIS, JOYCELIA
Entity type:Individual
Prefix:
First Name:JOYCELIA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8491 HOSPITAL DR STE 301
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2412
Mailing Address - Country:US
Mailing Address - Phone:770-325-4070
Mailing Address - Fax:
Practice Address - Street 1:4827 OLD NATIONAL HWY # 1216
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30337-6234
Practice Address - Country:US
Practice Address - Phone:770-325-4070
Practice Address - Fax:404-908-0340
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical