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NPI Code Detail

MEDICARE: MR. SCOTT WADE SEIBERT MSW, LCSW, CSAYC

MEDICARE:  MR. SCOTT WADE SEIBERT  MSW, LCSW, CSAYC
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
11041C0700XClinical Social Worker34006546AIN

General Provider Information

NPI Number : 1942556352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT WADE SEIBERT MSW, LCSW, CSAYC
Provider Business Mailing Address
First Line : 2159 MERIDIAN SPRINGS LN
Second Line :
City : GREENFIELD
State : IN
Zip : 46140-7282
Country : US
Telephone Number : 317-498-2121
Fax Number :
Provider Business Practice Location Address
First Line : 320 N TIBBS AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-4064
Country : US
Telephone Number : 317-630-5215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2012
Last Update Date : 08/03/2012

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Directions to “ MR. SCOTT WADE SEIBERT MSW, LCSW, CSAYC” Practice Location

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