Provider Demographics
NPI:1104577881
Name:SIEBOLD, AMBER (MA, LPC-IT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:SIEBOLD
Suffix:
Gender:F
Credentials:MA, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:832-548-5000
Mailing Address - Fax:
Practice Address - Street 1:400 KEENE ST
Practice Address - Street 2:
Practice Address - City:GALENA PARK
Practice Address - State:TX
Practice Address - Zip Code:77547-3200
Practice Address - Country:US
Practice Address - Phone:832-548-5000
Practice Address - Fax:713-351-7361
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5166OtherSTATE LICENSE