Provider Demographics
NPI:1639969504
Name:LEWIS, KENDRA MONET (LPC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:MONET
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 SANDY RD
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-8229
Mailing Address - Country:US
Mailing Address - Phone:478-213-6234
Mailing Address - Fax:
Practice Address - Street 1:2738 SANDY RD
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-8229
Practice Address - Country:US
Practice Address - Phone:478-213-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC041243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional