Healthcare Provider Details

I. General information

NPI: 1548711807
Provider Name (Legal Business Name): MAUREEN WISZKON MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAUREEN BISHOP

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 MUNICIPAL DR
ARNOLD MO
63010-1012
US

IV. Provider business mailing address

227 MAIN ST
FESTUS MO
63028-1952
US

V. Phone/Fax

Practice location:
  • Phone: 636-931-2700
  • Fax:
Mailing address:
  • Phone: 636-931-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2016008376
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2016008376
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: