Active NPI
Lanina Elizabeth Mompremier, PHD
- Clinical Psychologist
- Stone MTN, GA
National Provider Identifier
1780242164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY1000830
- Practice address
- 5011 Oak Tree LN
Stone MTN, GA 30087-3289 - Phone
- (240) 339-3518
- NPI assigned
- May 31, 2019
- Last updated
- May 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 08100004543 | VA | |
| Clinical Psychologist | 103TC0700X | 05139 | MD | |
| Clinical Psychologist | 103TC0700X | PSY1000830 | DC | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- 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
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Stone Mountain, GA
- NPI 1730981713
-
- Clinical Social Worker
- Denver, CO
- NPI 1760854442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1780242164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1227 ROCKBRIDGE RD. SW",
"address_2": "STE 208, BOX 364",
"city": "STONE MOUTAIN",
"state": "GA",
"postal_code": "30087",
"telephone_number": "240-339-3518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5011 OAK TREE LN",
"city": "STONE MTN",
"state": "GA",
"postal_code": "300873289",
"telephone_number": "240-339-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOMPREMIER",
"first_name": "LANINA",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "08100004543",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05139",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "PSY1000830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stone MTN, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.