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Individual
STACEY SEIBOLD
Active
Individual
STACEY SEIBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
150.101754
IL
1041C0700X
Clinical Social Worker
Primary
149.020141
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.020141
LCSW
IL
01
—
150.101754
LSW
IL
Enumeration date
11/09/2016
Last updated
04/06/2023
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