Provider Demographics
NPI:1871790873
Name:LEMONS-TIERNAN, MELISSA LYNNE (LPE-I)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNNE
Last Name:LEMONS-TIERNAN
Suffix:
Gender:F
Credentials:LPE-I
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:LYNNE
Other - Last Name:LEMONS-TIERNAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:125 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6478
Mailing Address - Country:US
Mailing Address - Phone:501-624-7111
Mailing Address - Fax:
Practice Address - Street 1:125 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6478
Practice Address - Country:US
Practice Address - Phone:501-624-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR02-10EI103TC1900X
AR02-10E103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR9219311OtherAETNA
AR116399726Medicaid
AR1871790873OtherTRUE BLUE
AR1871790873OtherHEALTH ADVANTAGE
AR1871790873OtherBCBS OF ARKANSAS