Provider Demographics
NPI:1114153772
Name:SIEGFRIED, LOREE (CSW-PIP, LCSW)
Entity Type:Individual
Prefix:
First Name:LOREE
Middle Name:
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:CSW-PIP, LCSW
Other - Prefix:
Other - First Name:LOREE
Other - Middle Name:
Other - Last Name:GRECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19262 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:SD
Mailing Address - Zip Code:57788-8100
Mailing Address - Country:US
Mailing Address - Phone:605-939-0296
Mailing Address - Fax:
Practice Address - Street 1:1420 NORTH AVE STE 5
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1543
Practice Address - Country:US
Practice Address - Phone:605-939-0296
Practice Address - Fax:605-939-0296
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SD31411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health