MEDICARE: MR. DEREK ALLEN SEIFERT CT

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	C.2405606-TRNE	OH

General Provider Information

NPI Number	:	1780494138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEREK ALLEN SEIFERT CT

Provider Business Mailing Address
First Line	:	19318 ALPINE DR
Second Line	:
City	:	LAWRENCEBURG
State	:	IN
Zip	:	47025-9336
Country	:	US
Telephone Number	:	513-236-3965
Fax Number	:

Provider Business Practice Location Address
First Line	:	8040 HOSBROOK RD STE 320
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2908
Country	:	US
Telephone Number	:	888-830-0347
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	02/12/2026

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