Individual
MR. GALEN W. SIEVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCC-S, LICDC-CS
Contact information
Practice address
3445 S MAIN ST, COVENTRY TOWNSHIP, OH 44319-3028
(330) 644-4095
Mailing address
1506 WOODBINE AVE, AKRON, OH 44313-7632
(330) 622-5111
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
051036
OH
101YP2500X
Professional Counselor
Primary
E7470
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164036
—
OH
Enumeration date
08/19/2006
Last updated
04/28/2020
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