Provider Demographics
NPI:1154699023
Name:RISSMAN, DENNIS L (M A, LPC)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:L
Last Name:RISSMAN
Suffix:
Gender:M
Credentials:M A, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7918 JONES MALTSBERGER RD
Mailing Address - Street 2:N - 1
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6944
Mailing Address - Country:US
Mailing Address - Phone:512-608-3139
Mailing Address - Fax:
Practice Address - Street 1:7918 JONES MALTSBERGER RD
Practice Address - Street 2:N - 1
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6944
Practice Address - Country:US
Practice Address - Phone:512-608-3139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health