DR. LISA L CLARK (NPI# 1396754370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396754370 |
| Entity Type | Individual |
| Full Name | DR. LISA L CLARK |
| Credential | PH.D. |
| Practice Address |
8134 Country Village Dr #102 Cordova TN 38016 |
| Mailing Address |
Po Box 341065 Memphis TN 38184-1065 |
| Practice Telephone | 9017568398 |
| Practice Fax Number | 9017568701 |
| Mailing Telephone | 9013852342 |
| Mailing Fax Number | 9013820140 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
HSP-1188 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3682232 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154776912 | Lisa Clark | Counselor | 8722 Heaton St, New Orleans, LA 70118-2616 | 2016-04-29 |
| 1548694383 | Lisa G Clark | Speech-Language Pathologist | 2405 Champaign Ave, Mattoon, IL 61938-2646 | 2013-08-28 |
| 1073857801 | Lisa Ann Clark | Specialist | 1110 Chenango St, Binghamton, NY 13901-1668 | 2012-11-16 |
| 1952680324 | Lisa S Clark | Counselor | 1223 Meadow Lake Rd, Rockledge, FL 32955-8403 | 2011-08-16 |
| 1134456445 | Lisa Lynn Clark | Occupational Therapist | 85 Lunt Rd, Brunswick, ME 04011-7289 | 2009-11-06 |
| 1437485836 | Lisa Landers Clark | Counselor | 1 Waterford Ln, Savannah, GA 31411-1305 | 2009-10-20 |
| 1710146220 | Lisa M Clark | Nurse Practitioner | University Hosp Medical Center Stony Brk, Dept Pediatrics Hsc 11th Floor, Stony Brook, NY 11794-0001 | 2008-06-09 |
| 1376742841 | Lisa M Clark | Specialist | 4308 N 26th St, Tacoma, WA 98407-5211 | 2007-07-15 |
| 1356453260 | Lisa M Clark | Dentist | Bonham Family Dentistry, 101 E 9th Street, Bonham, TX 75418 | 2006-08-31 |
| 1598779100 | Lisa Bardy Clark | Family Medicine | 12815 Highway 98 West, Suite 116, Destin, FL 32550 | 2006-07-28 |
| Street Address |
8134 COUNTRY VILLAGE DR #102 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427076991 | John Sherwood Leite | Psychologist | 8134 Country Village Dr, Suite 102, Cordova, TN 38016-2029 | 2006-07-17 |
| 1821234758 | George Albert Tsirgiotis | Counselor | 8134 Country Village Dr, Suite 102, Cordova, TN 38016-2029 | 2008-12-24 |
| 1841459641 | Barry Franklin Thompson | Psychiatry & Neurology | 8134 Country Village Dr, Suite 102, Cordova, TN 38016-2029 | 2008-06-05 |
| 1821208042 | Catherine Marie Collins | Psychologist | 8134 Country Village Dr, Suite 102, Cordova, TN 38016-2029 | 2007-05-23 |
| 1356499826 | Judy P King | Social Worker | 8134 Country Village Dr, Suite 102, Cordova, TN 38016 | 2007-01-08 |
| 1720006281 | Ricky Lane Mcphail | Psychologist | 8134 Country Village Dr, Suite 102, Cordova, TN 38016 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548886872 | Megan Scott Bolton | Physical Therapist | 8110 Cordova Road Suite 107, Cordova, TN 38016 | 2020-06-23 |
| 1477195451 | Jacqueline Reeves Thomas | Counselor | Memphis Veterans Affairs Medical Center (vamc), 1030 Jefferson Ave, Memphis, TN 38016 | 2019-10-11 |
| 1376195842 | Robert Cody Heismann | Physical Therapist | 8110 Cordova Rd, Ste 107, Cordova, TN 38016 | 2019-07-15 |
| 1881189702 | Carolyn Bean | Home Health Aide | 1786 Beaver Trail Dr, Cordova, TN 38016 | 2018-06-22 |
| 1255776886 | Suzanne Elaine Baker | Family Medicine | 2257 North Germantown Parkway, Memphis, TN 38016 | 2013-05-09 |
| 1487806683 | Janet Lee Ferrell | Counselor | 1340 Siskin Drive, Cordova, TN 38016 | 2008-10-21 |
| 1114186624 | Rebecca L Bills | Optometrist | 1795 N Germantown Pkwy, Cordova, TN 38016 | 2008-06-09 |
| 1679784128 | Linda Kay Yates | Emergency Medicine | 1401 Dexter Lane, Cordova, TN 38016 | 2007-05-25 |
| 1417168386 | Healthquest | Psychiatry & Neurology | 58 Timber Creek, Cordova, TN 38016 | 2007-05-24 |
| 1114079795 | Barbara T Henking | Psychologist | 8134 Country Village, #102, Cordova, TN 38016 | 2007-01-17 |
| Find all providers in zip 38016 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447873906 | Virtual Adhd Services and Testing | Psychologist | 8935 Magnolia Leaf Cv, Cordova, TN 38018-7413 | 2020-05-19 |
| 1720635030 | Amy Rebekah Murrell | Psychologist | 8558 Ericson Cv, Cordova, TN 38018-7312 | 2019-08-21 |
| 1508280207 | Poonam Tavkar-conley | Psychologist | 1147 Cully Rd Ste 102, Cordova, TN 38018-8502 | 2014-02-15 |
| 1447698568 | Dr. Mary Wanat Pllc | Psychologist | 8820 Trinity Rd Ste 200, Cordova, TN 38018-2735 | 2013-06-11 |
| 1780759217 | Beth Lyons | Psychologist | 65 Germantown Ct Ste 417, Cordova, TN 38018-4259 | 2006-11-21 |
| 1255432258 | John Robert Hutson | Psychologist | 1540 Appleing Care Lane, 100, Cordova, TN 38016 | 2006-09-25 |
| 1184634362 | Geraldine Bishop Phd PC Inc | Psychologist | 1540 Appling Care Lane, Suite 100, Cordova, TN 38016 | 2006-08-09 |
| 1659306264 | Addie Guinn | Psychologist | 9215 Durhamshire Dr, Cordova, TN 38016-2361 | 2006-07-11 |
| 1265464630 | Wyatt Lee Nichols | Psychologist | 8142 Country Village Dr Ste 102, Cordova, TN 38016-2029 | 2006-07-07 |
| 1023064201 | Sheila L Cohen | Psychologist | 150 Timber Creek Dr, Suite 6, Cordova, TN 38018-4236 | 2006-05-26 |
| Find all providers in CORDOVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.