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DR. LISA CLARK PH.D. NPI 1952378226


NPI Information

NPI: 1952378226
Provider Name: DR. LISA CLARK, PH.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
225 MEDICAL WAY
RIVERDALE, GA
ZIP 30274
Phone: (678) 519-1038
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DR. Lisa Clark, PH.D. is a clinical psychologist in Riverdale, GA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Lisa Clark, PH.D. NPI is 1952378226. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

225 MEDICAL WAY
RIVERDALE, GA
ZIP 30274-522
Phone: (678) 519-1038
Fax: (770) 756-9195

The enumeration date for this NPI number is 3/4/2006 and was last updated on 2/10/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPSY002509GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000910929HMEDICAIDGEORGIA
2000910929FMEDICAIDGEORGIA
3000910929GMEDICAIDGEORGIA
4000910929KMEDICAIDGEORGIA
5000910929EMEDICAIDGEORGIA
6000910929LMEDICAIDGEORGIA
7000910929IMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.