Provider Demographics
NPI:1871690933
Name:SIEFKEN, SANDRA K (LPC, LISAC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:SIEFKEN
Suffix:
Gender:F
Credentials:LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 W BELL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3465
Mailing Address - Country:US
Mailing Address - Phone:602-863-0277
Mailing Address - Fax:602-843-8028
Practice Address - Street 1:4901 W BELL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3465
Practice Address - Country:US
Practice Address - Phone:602-863-0277
Practice Address - Fax:602-843-8028
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10450101Y00000X
AZLISAC1477101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)