Provider Demographics
NPI:1578540878
Name:SIEVERS, DANIEL M (LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:SIEVERS
Suffix:
Gender:M
Credentials:LCSW
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 556
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-0556
Mailing Address - Country:US
Mailing Address - Phone:812-494-9501
Mailing Address - Fax:812-494-9502
Practice Address - Street 1:300 N 1ST ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1252
Practice Address - Country:US
Practice Address - Phone:812-494-9510
Practice Address - Fax:812-494-9511
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001282A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000188302OtherANTHEM BLUE CROSS
IN343410OtherMHN
IN000000188302OtherANTHEM BLUE CROSS