Provider Demographics
NPI:1437333283
Name:SIEFERT COUNSELING CENTER
Entity Type:Organization
Organization Name:SIEFERT COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEFERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:217-443-1400
Mailing Address - Street 1:918 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-3965
Mailing Address - Country:US
Mailing Address - Phone:217-443-1400
Mailing Address - Fax:217-443-4727
Practice Address - Street 1:918 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3965
Practice Address - Country:US
Practice Address - Phone:217-443-1400
Practice Address - Fax:217-443-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL285738OtherMHN
IL139566OtherCOMMUNITY PARTNERS
IL9220867OtherBCBS
IL204959Medicare PIN