Individual
DR. JOHN SIVLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
380 SUWANNEE TRAIL STREET, BOWLING GREEN, KY 42103
(270) 901-5000
(270) 842-5268
Mailing address
1725 AZALEA CT, BOWLING GREEN, KY 42103-1343
(270) 901-5000
(270) 842-5268
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0893
KY
106H00000X
Marriage & Family Therapist
0398
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
08/15/2006
Last updated
04/04/2008
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