Individual
DR. HEATH K. LISENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMIN., LMHC
Contact information
Practice address
6322 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 203-0294
(260) 264-4581
Mailing address
6322 CONSTITUTION DR, FORT WAYNE, IN 46804-1518
(260) 203-0294
(260) 264-4581
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001625A
IN
Other
Enumeration date
09/25/2006
Last updated
04/22/2022
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