MEDICARE: ALANNA SIECK LICSW

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	118594	MA

General Provider Information

NPI Number	:	1861685513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALANNA SIECK LICSW

Provider Business Mailing Address
First Line	:	109 OAK ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02464-1492
Country	:	US
Telephone Number	:	617-467-4136
Fax Number	:	617-916-5081

Provider Business Practice Location Address
First Line	:	109 OAK ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02464-1492
Country	:	US
Telephone Number	:	617-467-4136
Fax Number	:	617-916-5081

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	04/22/2015

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Directions to “ ALANNA SIECK LICSW” Practice Location

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