Active NPI
Grant Steven Sisson, LPC
- Professional Counselor
- Athens, TX
National Provider Identifier
1821736216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 79296
- Practice address
- 101 Lila LN
Athens, TX 75751-2123 - Phone
- (903) 292-1766
- NPI assigned
- May 25, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 79296 | TX | Primary |
Addresses
Primary practice location
101 Lila LN
Athens, TX 75751-2123
Mailing address
9290 PR 5204
Athens, TX 75751-5565
Phone (903) 681-7046
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79296 | Other | TX | LPC LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79296 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653436800000",
"number": "1821736216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9290 PR 5204",
"city": "ATHENS",
"state": "TX",
"postal_code": "757515565",
"telephone_number": "903-681-7046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LILA LN",
"city": "ATHENS",
"state": "TX",
"postal_code": "757512123",
"telephone_number": "903-292-1766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISSON",
"first_name": "GRANT",
"middle_name": "STEVEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-25",
"last_updated": "2022-05-25",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "79296",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC LICENSE",
"identifier": "79296",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.