Lillee Clark is a Psychologist in Gainesville, Georgia. Lillee Clark practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Lillee Clark is 1922116508. The last update date is 2010-03-02.
Lillee Clark's current location address is 605 Green St Nw Ste B, Gainesville, Georgia. You can contact this provider via phone number 7705384800 and fax number 7705039299. The mailing address for Lillee Clark is 605 Green St Nw Ste B, Gainesville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lillee Clark |
|---|---|
| Address | 605 Green St Nw Ste B, Gainesville, Georgia |
| Phone Number | 7705384800 |
| Fax Number | 7705039299 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1922116508 |
|---|---|
| Provider Enumeration Date | 2006-08-25 |
| Last Updated Date | 2010-03-02 |
Provider Mailing Address Detail
| Address | 605 Green St Nw Ste B |
|---|---|
| City | Gainesville |
| State | Georgia (GA) |
| Post Code | 305013319 |
| Phone Number | 7705384800 |
| Fax Number | 7705039299 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 1290 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 00566354A | GA | -- |
Post Comment/ Review Below
What is the Lillee Clark's 1922116508?
The Lillee Clark's NPI (National Provider Identifier) Number is 1922116508. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Lillee Clark's physical address?
The Lillee Clark is physically located at 605 Green St Nw Ste B, in the city of Gainesville, GA, with the postal code 305013319.
What is Lillee Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Lillee Clark is Psychologist, and the taxonomy classification code that categorizes this area of expertise is 103T00000X.
On what date did Lillee Clark receive its 1922116508 assignment from the Centers for Medicare & Medicaid Services?
The Lillee Clark was assigned its 1922116508 on 2006-08-25, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Lillee Clark, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Lillee Clark, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2010-03-02.