Provider Demographics
NPI:1336377415
Name:SIEBERS, TRACY M (LPC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:M
Last Name:SIEBERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:M
Other - Last Name:FABIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1075 S LAKE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3194
Mailing Address - Country:US
Mailing Address - Phone:920-642-2571
Mailing Address - Fax:920-666-0946
Practice Address - Street 1:1075 S LAKE ST STE 206
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3194
Practice Address - Country:US
Practice Address - Phone:920-642-2571
Practice Address - Fax:920-666-0946
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4150-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100004141Medicaid