Provider Demographics
NPI:1942536925
Name:SIVERTSON, BARBARA ELIZABETH (MA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:SIVERTSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 RANCH DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4538
Mailing Address - Country:US
Mailing Address - Phone:608-448-5356
Mailing Address - Fax:
Practice Address - Street 1:5507 RANCH DR
Practice Address - Street 2:SUITE 207
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4538
Practice Address - Country:US
Practice Address - Phone:608-448-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1210087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional