Provider Demographics
NPI:1407361991
Name:SIEBENS, JANINE STEWART (LCSW)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:STEWART
Last Name:SIEBENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 STAR VIEW LN
Mailing Address - Street 2:
Mailing Address - City:RILEYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22650-1787
Mailing Address - Country:US
Mailing Address - Phone:540-860-1492
Mailing Address - Fax:
Practice Address - Street 1:817 CEDAR CREEK GRADE STE 202
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6460
Practice Address - Country:US
Practice Address - Phone:540-635-4144
Practice Address - Fax:540-450-2735
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040025241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical