Lanina Elizabeth Mompremier, PHD
Individual provider Active NPI Clinical Psychologist · Stone MTN, GA
NPI 1780242164 · NPPES record last updated May 31, 2019
Key facts
- NPI
- 1780242164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY1000830 (DC)
- Practice address
- 5011 Oak Tree LN
Stone MTN, GA 30087-3289 - Phone
- (240) 339-3518
- NPI assigned
- May 31, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1000830 | DC | MD | Clinical Psychologist |
| 05139 | MD | MD | Clinical Psychologist |
| 08100004543 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creating Sustaining Joy LLC | Clinical | Current |
Accepting new patients |
| Sondermind Provider Network LLC | Clinical | Past | Accepting new patients |
Locations
1227 Rockbridge Rd
Ste 208
Stone Mountain, GA 30087
Phone (404) 828-0220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 08100004543 | VA | |
| Clinical Psychologist | 103TC0700X | 05139 | MD | |
| Clinical Psychologist | 103TC0700X | PSY1000830 | DC | Yes |
Addresses
Primary practice location
5011 Oak Tree LN
Stone MTN, GA 30087-3289
Mailing address
1227 Rockbridge Rd. SW
Ste 208, Box 364
Stone Moutain, GA 30087
Phone (240) 339-3518
Other providers in Stone MTN, GA
- Mark Douglas Luell Sr.
- Mansfield Pharmacy,Inc
- Robert L. McNeil
- Yvonne M McNeil
- Tyana Lashun Mizell
- Nadine Ave Nelson
- Kelly Ochu
- Marie D Saturne
- Timothy D Scott
- Olivia Elaine Smith
All providers in Stone MTN, GA · Clinical Psychologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.