Provider Demographics
NPI:1609544642
Name:SIEBERT, LILLIAN (LPC-T)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:SIEBERT
Suffix:
Gender:F
Credentials:LPC-T
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:SIEBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5106 BALTIMORE AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2464
Mailing Address - Country:US
Mailing Address - Phone:614-439-2824
Mailing Address - Fax:
Practice Address - Street 1:1707 E CEDAR ST STE 102
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1886
Practice Address - Country:US
Practice Address - Phone:816-977-3178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03909-T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional