Provider Demographics
NPI:1427601277
Name:WISKER, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WISKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 MILLSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-7463
Mailing Address - Country:US
Mailing Address - Phone:317-604-7119
Mailing Address - Fax:
Practice Address - Street 1:1442 MILITARY CUTOFF RD UNIT B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3605
Practice Address - Country:US
Practice Address - Phone:910-270-9995
Practice Address - Fax:910-270-9905
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008570A1041C0700X
NCC0133611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical