Individual provider Active NPI

Janny Ketsana Sivilay, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1821583089
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05501 Issued in KS
Practice address
4601 E Douglas Ave Ste 150
Wichita, KS 67218-1032
Phone
(913) 451-8550
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2023046870 MO
Clinical Social Worker 1041C0700X 05501 KS Primary

Addresses

Primary practice location

4601 E Douglas Ave Ste 150
Wichita, KS 67218-1032

Mailing address

4601 E Douglas Ave Ste 150
Wichita, KS 67218-1032
Phone (913) 451-8550

Other practice location 1

7501 College Blvd Ste 250
Overland Park, KS 66210-2505
Phone (913) 451-8550

Other identifiers 1

IdentifierTypeStateIssuer
200678500AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105003016 KS Practitioner - Clinical Social Worker 2860843604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023046870MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Janny Therapy LLC Current Accepting new patients

Locations

4601 E Douglas Ave
Ste 150
Wichita, KS 67218
Phone (423) 502-1508

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1821583089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 E DOUGLAS AVE STE 150",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181032",
            "telephone_number": "913-451-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 E DOUGLAS AVE STE 150",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672181032",
            "telephone_number": "913-451-8550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7501 College Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662102505",
            "country_code": "US",
            "telephone_number": "913-451-8550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIVILAY",
        "first_name": "JANNY",
        "middle_name": "KETSANA",
        "name_prefix": "Miss",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2023046870",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200678500A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.