Provider Demographics
NPI:1225330319
Name:HEIDI H SIEBERT, LMFT, LLC
Entity type:Organization
Organization Name:HEIDI H SIEBERT, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:SIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-829-4196
Mailing Address - Street 1:2490 BLACK ROCK TPKE
Mailing Address - Street 2:#341
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-2400
Mailing Address - Country:US
Mailing Address - Phone:203-829-4196
Mailing Address - Fax:
Practice Address - Street 1:5 EVERSLEY AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5821
Practice Address - Country:US
Practice Address - Phone:203-829-4196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1250106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty