Provider Demographics
NPI:1851854798
Name:SIENA COUNSELING, LLC
Entity Type:Organization
Organization Name:SIENA COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:MITCHELL OTT
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-251-7664
Mailing Address - Street 1:PO BOX 80355
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-0355
Mailing Address - Country:US
Mailing Address - Phone:907-251-7664
Mailing Address - Fax:907-328-0840
Practice Address - Street 1:2775 MACK BLVD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4004
Practice Address - Country:US
Practice Address - Phone:907-251-7664
Practice Address - Fax:907-459-8201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1770734857OtherNPI