Healthcare Provider Details

I. General information

NPI: 1598876484
Provider Name (Legal Business Name): DEBORAH ANN SIEFERT LCSW, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 N WALNUT ST
DANVILLE IL
61832-3965
US

IV. Provider business mailing address

918 N WALNUT ST
DANVILLE IL
61832-3965
US

V. Phone/Fax

Practice location:
  • Phone: 217-443-1400
  • Fax: 217-443-4727
Mailing address:
  • Phone: 217-443-1400
  • Fax: 217-443-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: