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General NPI Number Information
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NPI Number | 1245806900
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH SIESS LPC
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Gender | Male
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 1601 SW 89TH ST STE B200
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6365
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Country | US
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Telephone | 405-215-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 3386 W ROBINSON ST APT 48
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City | NORMAN
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State | OK
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Zip | 73072-3389
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Country | US
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Telephone | 405-343-4552
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11679
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License Number State | OK
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