MEDICARE: PATRICIA RAE SISAK BROWN LPC

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	101YM0800X	Mental Health Counselor	PC020086	PA
2	101YP2500X	Professional Counselor	PC020086	PA

General Provider Information

NPI Number	:	1942158704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA RAE SISAK BROWN LPC

Provider Business Mailing Address
First Line	:	625 RUSTIC LODGE RD
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3403
Country	:	US
Telephone Number	:	724-349-6320
Fax Number	:	724-349-6359

Provider Business Practice Location Address
First Line	:	625 RUSTIC LODGE RD
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3403
Country	:	US
Telephone Number	:	724-349-6320
Fax Number	:	724-349-6359

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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