DAVID LISAK (NPI# 1629562269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629562269 |
| Entity Type | Individual |
| Full Name | DAVID LISAK |
| Credential | PHD |
| Practice Address |
42 Agua Sarca Rd Placitas NM 87043-9404 |
| Practice Telephone | 6179474119 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
6295 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386185031 | David Lisak | Counselor | 256 Buena Vista St, Grass Valley, CA 95945-7239 | 2017-03-14 |
| Street Address |
42 AGUA SARCA RD |
| City | PLACITAS |
| State | NM |
| Zip Code | 87043-9404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174690234 | M Candis Mcguire Westby | Social Worker | 102 Vista Montana Loop, Placitas, NM 87043 | 2006-11-30 |
| 1043380041 | Judith Acosta | Social Worker | 16 Roadrunner Trail, Placitas, NM 87043 | 2006-11-08 |
| 1275562548 | Shara Moscinska | Counselor | 3 Homesteads Rd., Suite E, Placitas, NM 87043 | 2006-06-30 |
| 1922084201 | Rachael H Tingen | Dentist | 3 Homesteads Rd, Bldg. B, Placitas, NM 87043 | 2005-12-19 |
| 1861889354 | Justin Woods | Family Medicine | 10 Avenida Fresca, Placitas, NM 87043-8003 | 2015-04-22 |
| 1093043283 | Nadine Marie Hober | Nurse Practitioner | 25 Llano Del Norte, Placitas, NM 87043-8306 | 2009-11-26 |
| 1669773339 | Aaron Foster | Counselor | 9 Wildflower Ct, Placitas, NM 87043-8337 | 2010-11-10 |
| 1790789493 | Josef Nisenbaum | Radiology | 126 Diamond Tail Rd, Placitas, NM 87043-8338 | 2005-06-09 |
| 1518366434 | Irene Gale | Pharmacist | 3 Maize Trl, Placitas, NM 87043-8339 | 2014-08-15 |
| 1700218526 | Audrey Susan Petzold | Occupational Therapist | 32 Cuchilla De Lupe Rd, Placitas, NM 87043-8716 | 2013-08-02 |
| Find all providers in zip 87043 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205052 | Jaymes Vincent Fairfax-columbo | Psychologist | Unm School of Medicine Msc09 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-08-12 |
| 1528414828 | James Harrington | Psychologist | 2105 Retama Ct Se, Albuquerque, NM 87123-2463 | 2016-05-05 |
| 1457566721 | Clinton Ernest Rhyne | Psychologist | 110 Vista Sierra, Edgewood, NM 87015-6759 | 2007-05-11 |
| 1598841769 | Jude Pardee | Psychologist | 217 Camino Del Rincon, Santa Fe, NM 87506 | 2006-10-31 |
Please comment or provide details below to improve the information on DAVID LISAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.