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NPI Code Detail

MEDICARE: AMY LEWIS BEAR LPC

MEDICARE: AMY LEWIS BEAR LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC005920GA

General Provider Information

NPI Number : 1851688030
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LEWIS BEAR LPC
Provider Business Mailing Address
First Line : 1788 CENTURY BLVD NE STE B
Second Line :
City : ATLANTA
State : GA
Zip : 30345-3321
Country : US
Telephone Number : 404-592-1256
Fax Number :
Provider Business Practice Location Address
First Line : 1788 CENTURY BLVD NE STE B
Second Line :
City : ATLANTA
State : GA
Zip : 30345-3321
Country : US
Telephone Number : 404-592-1256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2011
Last Update Date : 07/07/2011

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Directions to “ AMY LEWIS BEAR LPC” Practice Location

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