Provider Demographics
NPI:1669185435
Name:LISKA, TAYLOR ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:LISKA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ELIZATHER
Other - Last Name:DUFUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-0777
Mailing Address - Country:US
Mailing Address - Phone:573-677-4425
Mailing Address - Fax:573-723-1474
Practice Address - Street 1:112 S PINE ST
Practice Address - Street 2:
Practice Address - City:ELDON
Practice Address - State:MO
Practice Address - Zip Code:65026-1581
Practice Address - Country:US
Practice Address - Phone:573-392-8030
Practice Address - Fax:573-765-3122
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022042905101YM0800X, 104100000X
MO20250137821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker