Provider Demographics
NPI:1912371121
Name:LISZKA, LEAH (LICSW)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:LISZKA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 P ST NW STE 610
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6920
Mailing Address - Country:US
Mailing Address - Phone:202-417-7868
Mailing Address - Fax:
Practice Address - Street 1:2000 P ST NW STE 610
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6920
Practice Address - Country:US
Practice Address - Phone:202-417-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-26
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189571041C0700X
DCLC500807411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical