Provider Demographics
NPI:1477945574
Name:SISLER COUNSELING SERVICES
Entity Type:Organization
Organization Name:SISLER COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:SISLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:434-390-2044
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23923-0007
Mailing Address - Country:US
Mailing Address - Phone:434-390-2044
Mailing Address - Fax:434-542-6110
Practice Address - Street 1:274 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23923-0007
Practice Address - Country:US
Practice Address - Phone:434-390-2044
Practice Address - Fax:434-542-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005096251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1831467091Medicaid