Provider Demographics
NPI:1235774514
Name:SIEBERT PSYCHOTHERAPY SERVICES
Entity Type:Organization
Organization Name:SIEBERT PSYCHOTHERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROLISIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:248-207-9242
Mailing Address - Street 1:32485 LEONA ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1227
Mailing Address - Country:US
Mailing Address - Phone:248-207-9242
Mailing Address - Fax:
Practice Address - Street 1:29501 GREENFIELD RD STE 132
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2250
Practice Address - Country:US
Practice Address - Phone:248-469-8141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health