Provider Demographics
NPI:1013245232
Name:SIVER, STACEY COHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:COHN
Last Name:SIVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3790 N FIRESTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1818
Mailing Address - Country:US
Mailing Address - Phone:224-456-7472
Mailing Address - Fax:847-545-0405
Practice Address - Street 1:2025 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4152
Practice Address - Country:US
Practice Address - Phone:224-456-7472
Practice Address - Fax:847-545-0405
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001501101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional