Individual
DR. LISA D TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, TLP, LCSW
Contact information
Practice address
652 PO BOX, AVONDALE ESTATES, GA 30002
(678) 517-9984
Mailing address
PO BOX 652, AVONDALE ESTATES, GA 30002-0652
(678) 517-9984
(404) 292-9424
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6362009715
MI
1041C0700X
Clinical Social Worker
6801084326
MI
1041C0700X
Clinical Social Worker
Primary
CSW003493
GA
1041S0200X
School Social Worker
400719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YMO800X
—
GA
Enumeration date
06/23/2009
Last updated
10/14/2025
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