Provider Demographics
NPI:1235383761
Name:SIFRI, TATIANA (MA, LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:TATIANA
Middle Name:
Last Name:SIFRI
Suffix:
Gender:F
Credentials:MA, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28379 DAVIS PKWY STE 801
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3032
Mailing Address - Country:US
Mailing Address - Phone:630-200-9698
Mailing Address - Fax:
Practice Address - Street 1:28379 DAVIS PKWY STE 801
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3032
Practice Address - Country:US
Practice Address - Phone:630-200-9698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.0006868101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health