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NPI Code Detail

MEDICARE: MS. LILA C SIDERAS MA, LPC

MEDICARE:  MS. LILA C SIDERAS  MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLAC-17241AZ
2101YP2500XProfessional Counselor19368AZ

General Provider Information

NPI Number : 1841754199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LILA C SIDERAS MA, LPC
Provider Business Mailing Address
First Line : 2500 N TUCSON BLVD STE 110
Second Line :
City : TUCSON
State : AZ
Zip : 85716-2463
Country : US
Telephone Number : 520-622-7368
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N TUCSON BLVD STE 110
Second Line :
City : TUCSON
State : AZ
Zip : 85716-2463
Country : US
Telephone Number : 520-622-7368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2019
Last Update Date : 03/06/2023

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Directions to “ MS. LILA C SIDERAS MA, LPC” Practice Location

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