Healthcare Provider Details

I. General information

NPI: 1881517613
Provider Name (Legal Business Name): MALIYAH SCISNEY LMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3562 E US HIGHWAY 30
WARSAW IN
46580-6720
US

IV. Provider business mailing address

415 KINCAIDE ST
WARSAW IN
46580-4725
US

V. Phone/Fax

Practice location:
  • Phone: 574-376-4489
  • Fax:
Mailing address:
  • Phone: 317-800-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88003355A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: