Provider Demographics
NPI:1699019695
Name:SEIBERT, ELISA JOY (PHD, MDIV)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:JOY
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:PHD, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 OREGON PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4272
Mailing Address - Country:US
Mailing Address - Phone:717-581-5255
Mailing Address - Fax:717-581-5259
Practice Address - Street 1:2550 KINGSTON RD STE 211
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-755-5736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017298103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling