MEDICARE: MS. ROBIN LEIGH SISKA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P005216	NC

General Provider Information

NPI Number	:	1407086481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN LEIGH SISKA LCSW

Provider Business Mailing Address
First Line	:	THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HL
Second Line	:	CB # 7160
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7160
Country	:	US
Telephone Number	:	919-942-7363
Fax Number	:	919-942-7379

Provider Business Practice Location Address
First Line	:	THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HL
Second Line	:	CB # 7160
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7160
Country	:	US
Telephone Number	:	919-942-7363
Fax Number	:	919-942-7379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	11/07/2011

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