MEDICARE: JOAN SIEVERT LCSW

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	1041C0700X	Clinical Social Worker	149.025654	IL
2	1041C0700X	Clinical Social Worker	2008034490	MO
3	1041C0700X	Clinical Social Worker	L7999	OR

General Provider Information

NPI Number	:	1407224561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN SIEVERT LCSW

Provider Business Mailing Address
First Line	:	10820 SUNSET OFFICE DR STE 240
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1030
Country	:	US
Telephone Number	:	314-530-6500
Fax Number	:	844-416-0598

Provider Business Practice Location Address
First Line	:	10820 SUNSET OFFICE DR STE 240
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1030
Country	:	US
Telephone Number	:	314-530-6500
Fax Number	:	844-416-0598

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

Provider Enumeration Date	:	09/07/2015
Last Update Date	:	07/09/2024

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