Provider Demographics
NPI:1548648231
Name:ZISLIS, LORI (LPC, NCC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:ZISLIS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE # 212
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4501
Mailing Address - Country:US
Mailing Address - Phone:215-579-2180
Mailing Address - Fax:
Practice Address - Street 1:770 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE # 212
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4501
Practice Address - Country:US
Practice Address - Phone:215-579-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional