Active NPI
Lisa Sikorski, LSW
- Social Worker
- Fairborn, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1600562
- Practice address
- 188 W Hebble Ave
Fairborn, OH 45324-4960 - Phone
- (937) 754-5911
- NPI assigned
- Jan 25, 2017
- Last updated
- Apr 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | S.1600562 | OH | |
| Social Worker | 104100000X | S.1600562 | OH | Primary |
Addresses
Primary practice location
188 W Hebble Ave
Fairborn, OH 45324-4960
Mailing address
9 Chesapeake PLZ
Chesapeake, OH 45619-1003
Phone (937) 754-5911
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0074861 | Other | OH | MEDICAID- ODADAS |
| 01-0693 | Other | OH | CARF CERTIFICATION |
| H130910 | Other | OH | MEDICARE GROUP PTAN |
| 0074946 | Other | OH | MEDICAID- ODMH |
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 |
|---|---|---|---|
| S.1600562 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Group Home, LLC | Current | Accepting new patients | |
| Access Counseling Services LLC | Mental Health | Past | Accepting new patients |
| Access Counseling Services, LLC | Past | Accepting new patients | |
| Phoenix Group Home, LLC | Past | Accepting new patients |
Locations
9 Chesapeake Plz
Chesapeake, OH 45619
Phone (740) 297-6019
188 W Hebble Ave
Fairborn, OH 45324
Phone (937) 754-5911
53 W Main St
Xenia, OH 45385
Phone (937) 242-1500
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/pathihc/r4/
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba PATH Integrated Healthcare
- Community/Behavioral Health Agency
- Portsmouth, OH
- NPI 1083146013
-
- Community/Behavioral Health Agency
- Middletown, OH
- NPI 1073884524
Mental Health
-
- Community/Behavioral Health Agency
- Middletown, OH
- NPI 1245583673
-
dba Path Behavioral Health- SUD
- Substance Abuse Rehabilitation Facility
- Cincinnati, OH
- NPI 1336654854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1851838056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 CHESAPEAKE PLZ",
"city": "CHESAPEAKE",
"state": "OH",
"postal_code": "456191003",
"telephone_number": "937-754-5911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 W HEBBLE AVE",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453244960",
"telephone_number": "937-754-5911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIKORSKI",
"first_name": "LISA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "S.1600562",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1600562",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID- ODADAS",
"identifier": "0074861",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARF CERTIFICATION",
"identifier": "01-0693",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "H130910",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID- ODMH",
"identifier": "0074946",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairborn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.