Provider Demographics
NPI:1770128225
Name:SALISBURY, ALISHA ANN (LCDC)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:ANN
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 WOODSTONE LOOP
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3268
Mailing Address - Country:US
Mailing Address - Phone:208-599-0885
Mailing Address - Fax:
Practice Address - Street 1:2405 S INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6817
Practice Address - Country:US
Practice Address - Phone:512-649-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15105101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)