Provider Demographics
NPI:1053819698
Name:LIESKE, SARAH (LMHP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LIESKE
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3827
Mailing Address - Country:US
Mailing Address - Phone:402-408-8836
Mailing Address - Fax:
Practice Address - Street 1:3535 PADDOCK RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3827
Practice Address - Country:US
Practice Address - Phone:402-408-8836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health