Provider Demographics
NPI:1891061057
Name:JAMES P SISLEY MA LMFT PLLC
Entity Type:Organization
Organization Name:JAMES P SISLEY MA LMFT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:SISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:734-757-8164
Mailing Address - Street 1:250 W EISENHOWER PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6933
Mailing Address - Country:US
Mailing Address - Phone:734-757-8164
Mailing Address - Fax:
Practice Address - Street 1:250 W EISENHOWER PKWY STE 190
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6933
Practice Address - Country:US
Practice Address - Phone:734-757-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES P SISLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006474106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty