Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jacob Michael Lisak

Individual provider Clinical Social Worker · NPI 1770417263

Mr. Jacob Michael Lisak is a Clinical Social Worker in Marshall, Michigan. Practices as a sole proprietor. Licensed in Indiana and Michigan.

Licensed in
IN, MI
In the registry since
2026
Specialties on file
2
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Practice location Address checks out

200 N Madison St
Marshall, MI 49068-1199
Phone: (269) 789-3862
Fax: (269) 789-8126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801108553 (MI)
Clinical Social Worker Taxonomy 1041C0700X · Licence 34009044A (IN)

Record details

NPI number1770417263
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 10, 2026
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address319 S Capital Ave, Athens, MI 49011-9335

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