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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