Provider Demographics
NPI:1124228200
Name:TALISPKI, AMY MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:TALISPKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 LINCOLN STREET
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517
Mailing Address - Country:US
Mailing Address - Phone:570-430-4526
Mailing Address - Fax:570-829-7781
Practice Address - Street 1:PROFESSIONAL ARTS BUILDING
Practice Address - Street 2:327 NORTH WASHINGTON AVE, SUITE 711
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503
Practice Address - Country:US
Practice Address - Phone:570-430-4526
Practice Address - Fax:570-829-7781
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011206101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional