Healthcare Provider Details

I. General information

NPI: 1144057886
Provider Name (Legal Business Name): LIESKE COUNSELING AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 BERLIN RD
HURON OH
44839-1909
US

IV. Provider business mailing address

619 BERLIN RD
HURON OH
44839-1909
US

V. Phone/Fax

Practice location:
  • Phone: 419-602-7141
  • Fax:
Mailing address:
  • Phone: 419-504-1485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLISON ONTKO
Title or Position: OWNER
Credential:
Phone: 419-504-1485