Provider Demographics
NPI:1982742045
Name:BROWN LEWIS, MARY LAJOYCE (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LAJOYCE
Last Name:BROWN LEWIS
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 310042
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31131-0042
Mailing Address - Country:US
Mailing Address - Phone:404-447-2199
Mailing Address - Fax:404-759-2460
Practice Address - Street 1:3915 CASCADE RD SW
Practice Address - Street 2:SUITE T-148
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8512
Practice Address - Country:US
Practice Address - Phone:404-447-2199
Practice Address - Fax:404-759-2460
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0020321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical