Individual
DIANE LISSFELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, ACSW, CAC-1
Contact information
Practice address
6948 N BLACK RIVER RD, CHEBOYGAN, MI 49721-9521
(231) 625-9937
(231) 625-9937
Mailing address
16231 NIPIGON RD, CHEBOYGAN, MI 49721-9341
(231) 420-0245
(231) 625-9937
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1-03082
MI
104100000X
Social Worker
6801066875
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220128
TRICARE
MI
Enumeration date
01/08/2007
Last updated
09/11/2025
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