Individual provider Active NPI

Lisa B. Alex, PH. D.

  • Clinical Psychologist
  • Memphis, TN
National Provider Identifier
1013981422
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P0000001125 Issued in TN
Practice address
4646 Poplar Ave Ste 419
Memphis, TN 38117-4434
Phone
(901) 682-6555
Fax
(901) 682-6901
NPI assigned
Feb 14, 2006
Last updated
Jul 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P0000001125 TN Primary

Addresses

Primary practice location

4646 Poplar Ave Ste 419
Memphis, TN 38117-4434

Mailing address

128 Alexander St
Memphis, TN 38111-4506
Phone (901) 682-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518001154 TN Practitioner - Clinical Psychologist 4486645603 Practice locations: Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4646 Poplar Ave
Suite 419
Memphis, TN 38117-4432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P0000001125TNMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1013981422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 ALEXANDER ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381114506",
            "telephone_number": "901-682-6555",
            "fax_number": "901-682-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 POPLAR AVE STE 419",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174434",
            "telephone_number": "901-682-6555",
            "fax_number": "901-682-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEX",
        "first_name": "LISA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.