Provider Demographics
NPI:1821583089
Name:SIVILAY, JANNY KETSANA (LSCSW)
Entity Type:Individual
Prefix:MISS
First Name:JANNY
Middle Name:KETSANA
Last Name:SIVILAY
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 COLLEGE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2505
Mailing Address - Country:US
Mailing Address - Phone:913-451-8550
Mailing Address - Fax:
Practice Address - Street 1:7501 COLLEGE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2505
Practice Address - Country:US
Practice Address - Phone:913-451-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230468701041C0700X
KS055011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200678500AMedicaid