1184886715 NPI number — CONSOLIDATED SCHOOL DIST 116

Table of content: DR. CATHY SIEBOLD DSW, LCSW (NPI 1972727675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184886715 NPI number — CONSOLIDATED SCHOOL DIST 116

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONSOLIDATED SCHOOL DIST 116
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184886715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
823 PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROSSER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99350-1264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-786-3323
Provider Business Mailing Address Fax Number:
509-786-2062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 GRANT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROSSER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99350-1122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-786-1820
Provider Business Practice Location Address Fax Number:
509-786-9672
Provider Enumeration Date:
06/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REYNOLDS
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
509-786-3323

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)