MEDICARE: BACK PORCH THERAPY PLLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1730730052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK PORCH THERAPY PLLC

Provider Business Mailing Address
First Line	:	435 WOODCREEK CIR
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3244
Country	:	US
Telephone Number	:	903-515-1474
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 WOODCREEK CIR
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3244
Country	:	US
Telephone Number	:	903-515-1474
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST/OWNER
Name	:	JOCELYN CHRISTINE SIPES
Credential	:	LCSW
Telephone Number	:	903-515-1474

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	02/05/2026

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