Provider Demographics
NPI:1619563038
Name:LISCHICK, CYNTHIA MARY (PHD, LPC, DVS)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MARY
Last Name:LISCHICK
Suffix:
Gender:F
Credentials:PHD, LPC, DVS
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:LISCHICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD LPC, DVS
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-0504
Mailing Address - Country:US
Mailing Address - Phone:908-303-1708
Mailing Address - Fax:
Practice Address - Street 1:14 PENN ELMER DR
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08510-1731
Practice Address - Country:US
Practice Address - Phone:908-303-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00383700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty