Provider Demographics
NPI:1316439995
Name:ZISKIND, KATHERINE L (LMFT, 500RYT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:ZISKIND
Suffix:
Gender:F
Credentials:LMFT, 500RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-3103
Mailing Address - Country:US
Mailing Address - Phone:860-984-1205
Mailing Address - Fax:
Practice Address - Street 1:461 MAIN ST
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-3103
Practice Address - Country:US
Practice Address - Phone:860-984-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001996106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist