Provider Demographics
NPI:1548324197
Name:FRISCIA, LYNORE ROSE (MS, LPC)
Entity type:Individual
Prefix:MISS
First Name:LYNORE
Middle Name:ROSE
Last Name:FRISCIA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SKYLANE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-1634
Mailing Address - Country:US
Mailing Address - Phone:414-881-4334
Mailing Address - Fax:
Practice Address - Street 1:5407 8TH AVE
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3715
Practice Address - Country:US
Practice Address - Phone:262-564-0067
Practice Address - Fax:262-652-1411
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3759-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional