Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa M Manderino

Individual provider Clinical Neuropsychologist · NPI 1790288066

Lisa M Manderino is a Clinical Psychologist in Louisville, Kentucky. Qualified in 2020, 6 years ago. Practices with Aptiva Health, a 38-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2018
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Practice location Address checks out

3615 Newburg Rd
Louisville, KY 40218-3368
Phone: (502) 909-0772
Fax: (855) 859-0123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X

Record details

NPI number1790288066
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 13, 2018
Last updated in NPPESOctober 13, 2022
Certification dateOctober 13, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Aptiva Health — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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