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Organization

LISS & ASSOC., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAY L LISS M.D. (PRESIDENT)
(314) 961-9871
Entity
Organization

Contact information

Practice address
8711 WATSON RD, SUITE 100, SAINT LOUIS, MO 63119-5100
(314) 961-9871
(314) 961-9877
Mailing address
8711 WATSON RD, SUITE 100, SAINT LOUIS, MO 63119-5100
(314) 961-9871
(314) 961-9877

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
990001485
MEDICARE PTAN
MO
Enumeration date
10/02/2006
Last updated
07/01/2015
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