Provider Demographics
NPI:1265869234
Name:SICKLER, JANA LYNN (PLMHP)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:LYNN
Last Name:SICKLER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1763
Mailing Address - Country:US
Mailing Address - Phone:308-395-1067
Mailing Address - Fax:308-395-1060
Practice Address - Street 1:4111 4TH AVE STE 38
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2885
Practice Address - Country:US
Practice Address - Phone:308-365-0014
Practice Address - Fax:308-865-0017
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10084101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health