Provider Demographics
NPI:1760784292
Name:SIEGL, KERRIE BYRNES (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KERRIE
Middle Name:BYRNES
Last Name:SIEGL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:KERRIE
Other - Middle Name:ERIN
Other - Last Name:BYRNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFTA
Mailing Address - Street 1:6591 SALEM DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4730
Mailing Address - Country:US
Mailing Address - Phone:317-459-5221
Mailing Address - Fax:317-247-8935
Practice Address - Street 1:3021 E 98TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2938
Practice Address - Country:US
Practice Address - Phone:317-459-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-05
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001788A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist