Provider Demographics
NPI:1760957583
Name:SIELSCHOTT, SHARON D (LPC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:SIELSCHOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 NE BARBERRY DR
Mailing Address - Street 2:
Mailing Address - City:ADAIR VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9593
Mailing Address - Country:US
Mailing Address - Phone:541-740-5894
Mailing Address - Fax:
Practice Address - Street 1:8025 NE BARBERRY DR
Practice Address - Street 2:
Practice Address - City:ADAIR VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97330-9593
Practice Address - Country:US
Practice Address - Phone:541-740-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2021-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4582101YM0800X
ORC5148101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health