Richard L Listiak
Cognitive & Behavioral Psychologist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
Richard L Listiak
Cognitive & Behavioral Psychologist
1836 South Ave
La Crosse
, Wisconsin 54601-5429
(608) 782-7300
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About
Features
Specialties
- Cognitive & Behavioral Psychologist
Languages spoken
- English
Location
First Address
- Richard L Listiak
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
Second Address
- Richard L Listiak
- 1836 South Ave
- La Crosse, WI
- Zip : 54601-5429
- Phone : (608) 782-7300
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TB0200X | Cognitive & Behavioral Psychologist | 455 | WI |
National Provider Identifier
| NPI | 1134125149 |
|---|---|
| Provider Name | Richard L Listiak |
| First Address | La Crosse, WI 54601-5429 |
| Second Address | La Crosse, WI 54601-5429 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/06/2005 |
| Last Update Date | 19/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 39059300 | (05) | WI |
| S17379 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.