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NPI Code Detail

MEDICARE: DR. KELLY MICHELLE LEWIS-ARTHUR PHD

MEDICARE: DR. KELLY MICHELLE LEWIS-ARTHUR PHD
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
1103TC0700XClinical PsychologistPSY003785GA

General Provider Information

NPI Number : 1164832630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY MICHELLE LEWIS-ARTHUR PHD
Provider Business Mailing Address
First Line : 2801 BUFORD HWY NE
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2149
Country : US
Telephone Number : 770-284-1044
Fax Number : 404-228-3860
Provider Business Practice Location Address
First Line : 3355 LENOX RD NE STE 1000
Second Line :
City : ATLANTA
State : GA
Zip : 30326-2000
Country : US
Telephone Number : 770-284-1044
Fax Number : 404-228-3860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2014
Last Update Date : 01/22/2025

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