Provider Demographics
NPI:1396904397
Name:STEAR, LISA SIRIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:SIRIAN
Last Name:STEAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SIRIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:10926 CARTERS OAK WAY
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2426
Mailing Address - Country:US
Mailing Address - Phone:678-684-8667
Mailing Address - Fax:
Practice Address - Street 1:8341 GRADY ST
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6910
Practice Address - Country:US
Practice Address - Phone:678-715-8233
Practice Address - Fax:678-715-9279
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002922103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical