Individual
BRIAN M LISSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1619 3RD AVE STE 202, NEW YORK, NY 10128-3459
(203) 994-5970
Mailing address
298 AUDUBON RD, ENGLEWOOD, NJ 07631-4311
(203) 994-5970
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
102247
NY
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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