Sisson Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SISSON COUNSELING SERVICES LLC

Practice address

407 4TH Ave SW
Zeeland, ND 58581-4047

Phone

(701) 595-5789

NPI assigned

Aug 21, 2019

Last updated

May 19, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly SissonNPI 1770906760

Title

Owner

Phone

(309) 645-9597

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kelly Sisson, LICSW

  • Clinical Social Worker
  • Zeeland, ND
  • NPI 1770906760
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1093362428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "ZEELAND",
            "state": "ND",
            "postal_code": "585810155",
            "telephone_number": "701-595-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 4TH AVE SW",
            "city": "ZEELAND",
            "state": "ND",
            "postal_code": "585814047",
            "telephone_number": "701-595-5789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave NE Ste 203",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "ND",
            "postal_code": "584013373",
            "country_code": "US",
            "telephone_number": "701-595-5789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SISSON COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "SISSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-645-9597"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Medical Center (AMC Zeeland Clinic)
• Dawn Rossow
• Kelly Sisson, LICSW

• Clinical Social Worker in Zeeland, ND
• Providers in Zeeland, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.