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General NPI Number Information
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NPI Number | 1932987633
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Entity Type | Individual
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Provider Name | KATHY LEE SIEPKER PHD, MSW, LCSW, CDP
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Gender | Female
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1705 W NORTHWEST HWY STE 175
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City | GRAPEVINE
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State | TX
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Zip | 76051-8124
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Country | US
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Telephone | 314-971-7258
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 W NORTHWEST HWY STE 175
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City | GRAPEVINE
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State | TX
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Zip | 76051-8124
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Country | US
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Telephone | 214-613-3074
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104496
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License Number State | TX
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