Healthcare Provider Details

I. General information

NPI: 1356872386
Provider Name (Legal Business Name): TRICIA LEMELLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 HAMMOND DR STE 600
ATLANTA GA
30328-5510
US

IV. Provider business mailing address

3300 N TRIUMPH BLVD STE 500
LEHI UT
84043-6475
US

V. Phone/Fax

Practice location:
  • Phone: 678-861-1832
  • Fax: 678-585-2259
Mailing address:
  • Phone: 801-821-2781
  • Fax: 801-901-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number105644
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: