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General NPI Number Information
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NPI Number | 1235774514
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Entity Type | Organization
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Legal Business Name | SIEBERT PSYCHOTHERAPY SERVICES
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 29501 GREENFIELD RD STE 132
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2250
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Country | US
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Telephone | 248-469-8141
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Fax |
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Provider Business Mailing Address
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Address Line | 32485 LEONA ST
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City | GARDEN CITY
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State | MI
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Zip | 48135-1227
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Country | US
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Telephone | 248-207-9242
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD THERAPIST
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Name | ROLISIA L SIEBERT
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Credential | MA LPC
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Telephone | 248-207-9242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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