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Contact Information

LISA CLARK ENTERPRISES, INC
2785 LAWRENCEVILLE HWY STE 207
DECATUR, GA30033-2515
 Phone: 678-519-1038
 Fax: 678-239-4720
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LISA CLARK ENTERPRISES, INC

NPI Number 1801022413
LBN Legal business name LISA CLARK ENTERPRISES, INC
Authorized official LISA CLARK - (CEO/PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/09/2009
Last updated 02/26/2018 - About 8 years ago
Identifiers
GA License # PSY002509
GA Medicaid 000910929O
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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