Provider Demographics
NPI:1871529636
Name:CLOYD, LISA LOEWINGER (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LOEWINGER
Last Name:CLOYD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MELANIE
Other - Last Name:LOEWINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:8693 FORESTER LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-7933
Mailing Address - Country:US
Mailing Address - Phone:919-924-1668
Mailing Address - Fax:
Practice Address - Street 1:1100 NW MAYNARD RD STE 140
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8707
Practice Address - Country:US
Practice Address - Phone:919-924-1668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4976103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist