Individual
DR. LISA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
225 MEDICAL WAY, RIVERDALE, GA 30274-2522
(678) 519-1038
(770) 756-9195
Mailing address
4557 MEADOW CREEK PATH, LITHONIA, GA 30038-7704
(678) 519-1038
(770) 756-9195
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002509
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000910929E
—
GA
05
—
000910929F
—
GA
05
—
000910929G
—
GA
05
—
000910929H
—
GA
05
—
000910929I
—
GA
05
—
000910929K
—
GA
05
—
000910929L
—
GA
Enumeration date
03/04/2006
Last updated
02/10/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us