Individual
JACQUELINE LISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MATS
Contact information
Practice address
8000 MELTON RD, GARY, IN 46403-3114
(219) 938-4651
(219) 938-4679
Mailing address
8000 MELTON RD, GARY, IN 46403-3114
(219) 938-4651
(219) 938-4679
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
33008998A
IN
1041C0700X
Clinical Social Worker
34010715A
IN
Other
Enumeration date
08/16/2019
Last updated
10/17/2023
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