Provider Demographics
NPI:1710057252
Name:SIEBER, DANIEL J (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:SIEBER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 31ST AVE APT 5B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-3612
Mailing Address - Country:US
Mailing Address - Phone:718-233-6283
Mailing Address - Fax:
Practice Address - Street 1:2540 31ST AVE APT 5B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-3612
Practice Address - Country:US
Practice Address - Phone:718-233-6283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0599261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00059926Medicaid
NY00059926Medicaid