Provider Demographics
NPI:1952406647
Name:SALZBERG, LISA F (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:F
Last Name:SALZBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 566232
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31156-6232
Mailing Address - Country:US
Mailing Address - Phone:404-237-3987
Mailing Address - Fax:404-237-3707
Practice Address - Street 1:7527 ROSWELL ROAD
Practice Address - Street 2:#566232
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-9997
Practice Address - Country:US
Practice Address - Phone:404-237-3987
Practice Address - Fax:404-237-3707
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00493677AMedicaid
GA00493677AMedicaid