Vladimir P Lisenko, LMHCNCC is a medicare enrolled "Counselor - Mental Health" provider in Manson, Washington. His current practice location is
750 Lakeshore Dr, Manson, Washington. You can reach out to his office (for appointments etc.) via phone at
(206) 714-9710.
Vladimir P Lisenko is licensed to practice in Washington (license number LH00010867) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104013390.
Healthcare Provider's Profile
Full Name | Vladimir P Lisenko |
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Gender | Male |
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Speciality | Counselor - Mental Health |
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Location | 750 Lakeshore Dr, Manson, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104013390
- Provider Enumeration Date: 10/01/2007
- Last Update Date: 01/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 4082057088
- Enrollment ID: I20240207000178
Medical Identifiers
Medical identifiers for Vladimir P Lisenko such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104013390 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | LH00010867 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vladimir P Lisenko is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Vladimir P Lisenko, LMHCNCC 750 Lakeshore Dr, Manson, WA 98831-9618 Ph: (206) 714-9710 | Vladimir P Lisenko, LMHCNCC 750 Lakeshore Dr, Manson, WA 98831-9618 Ph: (206) 714-9710 |
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