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Organization
GUARDIAN ALLIES COLLECTIVE LLC
Active
Organization
GUARDIAN ALLIES COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA MICHELLE LEWIS ED.D., LPES (CHIEF EXECUTIVE OFFICER)
(904) 472-6050
Entity
Organization
Contact information
Practice address
2155 N PARK LN STE 216, NORTH CHARLESTON, SC 29406-9261
(843) 969-0297
(854) 258-5167
Mailing address
6565 WARD PKWY, MELBOURNE, FL 32904-3636
(904) 472-6050
(854) 258-5167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LP1071
—
SC
Enumeration date
11/12/2025
Last updated
12/11/2025
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