Provider Demographics
NPI:1972308161
Name:SEIBERT, AMBER LEIGH (LAC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40B N RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PEDRICKTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08067-3524
Mailing Address - Country:US
Mailing Address - Phone:856-469-9817
Mailing Address - Fax:
Practice Address - Street 1:1919 KINGS HWY
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1619
Practice Address - Country:US
Practice Address - Phone:800-845-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00855600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health