Individual provider · Type 1 NPI

Jacob Michael Lisak

Clinical Social Worker · Marshall, MI

NPI number 1770417263 Active

Practice location

200 N Madison St
Marshall, MI 49068-1199

Call (269) 789-3862 Map

Fax (269) 789-8126

Mailing address

319 S Capital Ave
Athens, MI 49011-9335

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X34009044A (IN)
Clinical Social Worker Primary 1041C0700X6801108553 (MI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1770417263

Jacob Michael Lisak's National Provider Identifier is 1770417263, issued on Jun 10, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Marshall, MI. The record was last updated on Jun 10, 2026.