Provider Demographics
NPI:1972727675
Name:SIEBOLD, CATHY (DSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:
Last Name:SIEBOLD
Suffix:
Gender:F
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 BRATTLE ST APT 41
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4653
Mailing Address - Country:US
Mailing Address - Phone:917-209-3244
Mailing Address - Fax:
Practice Address - Street 1:246 BRATTLE ST APT 41
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4653
Practice Address - Country:US
Practice Address - Phone:917-209-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR019959-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical