MEDICARE: GARRISON, WISKERCHEN & COATES, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1336534361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRISON, WISKERCHEN & COATES, LTD

Provider Business Mailing Address
First Line	:	975 ROBERTA LN STE 104
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89431-6812
Country	:	US
Telephone Number	:	775-525-1616
Fax Number	:	775-201-0147

Provider Business Practice Location Address
First Line	:	975 ROBERTA LN STE 104
Second Line	:
City	:	SPARKS
State	:	NV
Zip	:	89431-6812
Country	:	US
Telephone Number	:	775-525-1616
Fax Number	:	775-201-0147

Authorized Official
Title or Position	:	OWNER
Name	:	JACOB RICHARD WISKERCHEN
Credential	:	MFT, NCC
Telephone Number	:	775-525-1616

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	03/25/2025

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Practice Location Address:

975 ROBERTA LN
SPARKS, NV
89431-6812

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1093073132 — MR. JACOB RICHARD WISKERCHEN JR. MFT, NCC
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975 ROBERTA LN UNIT 104
SPARKS, NV
89431-6812

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1043732571 — LISA RENEE SCHULTZ LMSW, CSW-I, CADC
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975 ROBERTA LN STE 104
SPARKS, NV
89431-6812

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1811498975 — STEVEN BOWEN LMSW, CSW-I
Practice Location Address:

975 ROBERTA LN STE 104
SPARKS, NV
89431-6812

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1205481116 — GLADYS CRESPIN-ALFARO MS, MFT
Practice Location Address:

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89431-6812

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Practice Fax: 775-201-0147

Directions to “GARRISON, WISKERCHEN & COATES, LTD ” Practice Location

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