Provider Demographics
NPI:1053551341
Name:SISK, JANA MEAGHER (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANA
Middle Name:MEAGHER
Last Name:SISK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1121 ESE LOOP323
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-9660
Mailing Address - Country:US
Mailing Address - Phone:903-581-0933
Mailing Address - Fax:903-581-3977
Practice Address - Street 1:1121 ESE LOOP323
Practice Address - Street 2:SUITE 204
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9660
Practice Address - Country:US
Practice Address - Phone:903-581-0933
Practice Address - Fax:903-581-3977
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX038581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX03858OtherSTATE LICENSE