Provider Demographics
NPI:1033401682
Name:LISCINSKI, MARY CATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:LISCINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21591
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1591
Mailing Address - Country:US
Mailing Address - Phone:501-547-1347
Mailing Address - Fax:
Practice Address - Street 1:320 OUACHITA AVE STE 214
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-5188
Practice Address - Country:US
Practice Address - Phone:501-547-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1612186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional