Provider Demographics
NPI:1205191103
Name:LIZARRAGA, CIARA D (LCMFT)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:D
Last Name:LIZARRAGA
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:CIARA
Other - Middle Name:N
Other - Last Name:DRESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMFT
Mailing Address - Street 1:3717 DECATUR AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2148
Mailing Address - Country:US
Mailing Address - Phone:301-539-9159
Mailing Address - Fax:
Practice Address - Street 1:3717 DECATUR AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2148
Practice Address - Country:US
Practice Address - Phone:301-539-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM464106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist