Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Carissa Marie Lane, PSYD

Individual provider Clinical Psychologist · NPI 1962128553

Dr. Carissa Marie Lane, PSYD is a Clinical Psychologist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2022.

Licensed in
PA
In the registry since
2022
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone: (215) 823-5800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PS019580 (PA)

Record details

NPI number1962128553
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedOctober 14, 2022
Last updated in NPPESOctober 14, 2022
Certification dateOctober 14, 2022

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