Provider Demographics
NPI:1083759013
Name:SEIBEL, THOMAS ALEXANDER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALEXANDER
Last Name:SEIBEL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-9429
Mailing Address - Country:US
Mailing Address - Phone:916-316-3024
Mailing Address - Fax:916-663-9317
Practice Address - Street 1:3175 SUNSET BLVD STE 104A
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3091
Practice Address - Country:US
Practice Address - Phone:916-316-3024
Practice Address - Fax:916-663-9317
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS214541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical