Individual
DR. LISA LORENCE DEL VALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
6135 PARK SOUTH DR STE 510, CHARLOTTE, NC 28210-0100
(704) 372-0670
Mailing address
6135 PARK SOUTH DR STE 510, CHARLOTTE, NC 28210-0100
(704) 372-0670
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2373
NC
103TC0700X
Clinical Psychologist
Primary
NC2373
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403W
BCBS INDIVIDUAL PROVIDER
NC
01
—
D4319
MEDCOST INDIVIDUAL PROVID
NC
Enumeration date
03/07/2007
Last updated
06/12/2025
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