Provider Demographics
NPI:1023103470
Name:SHOWALTER, LIESEL Y (LPC)
Entity type:Individual
Prefix:MRS
First Name:LIESEL
Middle Name:Y
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4225
Mailing Address - Country:US
Mailing Address - Phone:540-746-0446
Mailing Address - Fax:540-574-2214
Practice Address - Street 1:481 E MARKET ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4225
Practice Address - Country:US
Practice Address - Phone:540-746-0446
Practice Address - Fax:540-574-2214
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0802666MOtherSENTARA
VA010318297Medicaid
VA1164637518OtherGOUP NPI NUMBER
VA11716652OtherCAQH
VA235611OtherANTHEM
VA581665OtherVALUE OPTIONS
VA279188OtherCOMPSYCH
VAC05754OtherMEDICARE GROUP NUMBER