Jason Matthew Van Sickle, LCSW, MSCS, COR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-019731 Issued in IL

Practice address

2401 W Main St
Marion, IL 62959-1188

Phone

(618) 997-5311

Fax

(618) 998-5697

NPI assigned

Feb 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1114259207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311",
            "fax_number": "618-998-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311",
            "fax_number": "618-998-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LCSW, MSCS, COR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-01",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-019731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VA Medical Center
• VA Medical Center
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• Jason L Vallette, CRNA
• Vamc
• Anne Vana, RN
• Janice Lynn Vance, RN
• Emily Vandonselaar
• Liudmila Vasilets, MD
• Daniel Vaughn

• Clinical Social Worker in Marion, IL
• Providers in Marion, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.