Lisa D Taylor, PHD, TLP, LCSW
Individual provider Active NPI Clinical Social Worker · Avondale Estates, GA
NPI 1396973988 · NPPES record last updated Oct 14, 2025
Key facts
- NPI
- 1396973988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW003493 (GA)
- Practice address
- 652 PO Box
Avondale Estates, GA 30002 - Phone
- (678) 517-9984
- NPI assigned
- Jun 23, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
262 3Rd Ave
Avondale Estates, GA 30002-1128
Phone (678) 517-9984
PO Box
Suite 652
Avondale Estates, GA 30002
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090901000652 | GA | Practitioner - Clinical Social Worker | 4385799071 | Practice locations: Avondale Estates, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6362009715 | MI | MD | Psychologist |
| 6801084326 | MI | MD | Clinical Social Worker |
| 400719 | GA | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Lisa Taylor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW003493 | GA | Yes |
| Clinical Social Worker | 1041C0700X | 6801084326 | MI | |
| Psychologist | 103T00000X | 6362009715 | MI | |
| School Social Worker | 1041S0200X | 400719 | GA |
Addresses
Primary practice location
652 PO Box
Avondale Estates, GA 30002
Mailing address
PO Box 652
Avondale Estates, GA 30002-0652
Phone (678) 517-9984
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101YMO800X | Medicaid | GA |
Other providers in Avondale Estates, GA
- Amer Sibai
- Anneliese Amanda Singh
- Charise Smith
- Amanda Stentiford
- Amy Lynne Stern
- Third Endeavor LLC
- Kevin Thrailkill
- John E. Titak
- Trident Counseling and Consultation, LLC
- Jacqueline Varnum
All providers in Avondale Estates, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.