Provider Demographics
NPI:1730856824
Name:ORDZIEJEWSKI, ALISA (MA, LMHC-A, NCC)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:ORDZIEJEWSKI
Suffix:
Gender:F
Credentials:MA, LMHC-A, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S 5TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2990
Mailing Address - Country:US
Mailing Address - Phone:219-316-4373
Mailing Address - Fax:
Practice Address - Street 1:350 INDIAN BOUNDARY RD
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1511
Practice Address - Country:US
Practice Address - Phone:888-883-8433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IN88001546A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health