Lisa Clark Enterprises, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002509 Issued in GA

Legal business name

LISA CLARK ENTERPRISES, INC

Practice address

2785 Lawrenceville Hwy Ste 207
Decatur, GA 30033-2515

Phone

(678) 519-1038

Fax

(678) 239-4720

NPI assigned

Jun 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Clark, PH.D.NPI 1952378226

Title

Ceo/President/Owner

Phone

(404) 276-3037

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Clark, PH.D.

  • Clinical Psychologist
  • Riverdale, GA
  • NPI 1952378226
  NPD (past) Authorized official

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1801022413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 NORBURY CV SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805206",
            "telephone_number": "678-519-1038",
            "fax_number": "678-239-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 LAWRENCEVILLE HWY STE 207",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332515",
            "telephone_number": "678-519-1038",
            "fax_number": "678-239-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA CLARK ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO/PRESIDENT/OWNER",
        "authorized_official_telephone_number": "404-276-3037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000910929O",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Williams Lintz, PA
• Merrick Blaine Lipman, M.D
• Dejah Lipsey
• Mary Ellen Liptak, R.N.
• Danna Lipton
• Lisa Czech LLC
• Emily Crocker Lisi, MS
• Catherine Lisicia
• Lissy Isaacson LCSW LLC
• Lithonia Dialysis Center

• Clinical Psychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.