Individual
JOHN J LISY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
24500 CENTER RIDGE RD STE 110, WESTLAKE, OH 44145-5604
(440) 787-6311
Mailing address
2419 DERBYSHIRE RD, CLEVELAND HTS, OH 44106-2725
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E0000387
OH
1041C0700X
Clinical Social Worker
Primary
I0000993
OH
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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