Provider Demographics
NPI:1386029460
Name:PLISKA, MICHELLE ANNE (NCC, LPC, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANNE
Last Name:PLISKA
Suffix:
Gender:F
Credentials:NCC, LPC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N TAMARAC AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005
Mailing Address - Country:US
Mailing Address - Phone:605-940-2844
Mailing Address - Fax:
Practice Address - Street 1:1500 S SYCAMORE AVE STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3711
Practice Address - Country:US
Practice Address - Phone:605-223-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7118101Y00000X
SDLPC-MH30739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor