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General NPI Number Information
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NPI Number | 1033401682
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Entity Type | Individual
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Provider Name | MARY CATHERINE LISCINSKI LPC
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Gender | Female
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 320 OUACHITA AVE STE 214
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City | HOT SPRINGS
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State | AR
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Zip | 71901-5188
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Country | US
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Telephone | 501-547-1347
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21591
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City | HOT SPRINGS
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State | AR
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Zip | 71903-1591
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Country | US
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Telephone | 501-547-1347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1612186
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License Number State | AR
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