MEDICARE: MRS. NANCY GAIL SIEVER MA, PSYCHOTHERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	10233	CO
2	101YP2500X	Professional Counselor	5746	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5746	OTHER	CO	LPC
2	10233	OTHER	CO	COLORADO REGISTRATION (DORA)

General Provider Information

NPI Number	:	1285884221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY GAIL SIEVER MA, PSYCHOTHERAPIST

Provider Business Mailing Address
First Line	:	1646 VICKERS DR STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-8123
Country	:	US
Telephone Number	:	719-685-6631
Fax Number	:

Provider Business Practice Location Address
First Line	:	1646 VICKERS DR STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-685-6631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	02/12/2019

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