Individual
LISA RIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC-I
Contact information
Practice address
400 SOUTH MAIN ST SUITE C, MAULDIN, SC 29662
(864) 371-2853
(866) 808-0926
Mailing address
400 SOUTH MAIN ST SUITE C, MAULDIN, SC 29662
(864) 371-2853
(866) 808-0926
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6748
SC
101YP2500X
Professional Counselor
Primary
6298
SC
Other
Enumeration date
09/12/2016
Last updated
04/30/2019
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