Individual
MADISON LISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
560 W CANFIELD AVE STE 300, COEUR D ALENE, ID 83815-7953
(208) 758-7111
Mailing address
560 W CANFIELD AVE STE 300, COEUR D ALENE, ID 83815-7953
(208) 758-7111
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4071375
ID
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/08/2020
Last updated
03/25/2026
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