Provider Demographics
NPI:1528366994
Name:SEIBLY, CARRON JOY
Entity Type:Individual
Prefix:MS
First Name:CARRON
Middle Name:JOY
Last Name:SEIBLY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CARRON
Other - Middle Name:JOY
Other - Last Name:KAPINIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90390 SHEFFLER RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:OR
Mailing Address - Zip Code:97437-9786
Mailing Address - Country:US
Mailing Address - Phone:541-890-6050
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3758
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health