Provider Demographics
NPI:1093362428
Name:SISSON COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:SISSON COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SISSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-645-9597
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:ND
Mailing Address - Zip Code:58581-0155
Mailing Address - Country:US
Mailing Address - Phone:701-595-5789
Mailing Address - Fax:
Practice Address - Street 1:407 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:ND
Practice Address - Zip Code:58581-4047
Practice Address - Country:US
Practice Address - Phone:701-595-5789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty