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General NPI Number Information
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NPI Number | 1356841209
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Entity Type | Organization
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Legal Business Name | TABITHA SIELOFF LCSW PLLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 144 PINE ST STE 140
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City | KINGSTON
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State | NY
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Zip | 12401
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Country | US
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Telephone | 845-768-2295
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Fax | 845-523-1251
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Provider Business Mailing Address
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Address Line | 144 PINE ST STE 140
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City | KINGSTON
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State | NY
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Zip | 12401-4946
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Country | US
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Telephone | 845-768-2295
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Fax | 845-523-1251
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Authorized Official
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Title or Position | OWNER
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Name | TABITHA SIELOFF
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Credential |
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Telephone | 845-768-2295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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