Provider Demographics
NPI:1932987633
Name:SIEPKER, KATHY LEE (PHD, MSW, LCSW, CDP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:LEE
Last Name:SIEPKER
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SADDLE TREE TRL
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3966
Mailing Address - Country:US
Mailing Address - Phone:214-613-3074
Mailing Address - Fax:
Practice Address - Street 1:306 SADDLE TREE TRL
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3966
Practice Address - Country:US
Practice Address - Phone:314-971-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1044961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty