Provider Demographics
NPI:1164277711
Name:BISNETT, ALISHA L (LLPC)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:L
Last Name:BISNETT
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3690 STATE RD
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-4064
Mailing Address - Country:US
Mailing Address - Phone:810-956-2867
Mailing Address - Fax:
Practice Address - Street 1:9844 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:IRA
Practice Address - State:MI
Practice Address - Zip Code:48023-2813
Practice Address - Country:US
Practice Address - Phone:586-716-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451023572101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional