Sievert, Galen W.

Sievert, Galen W. is an individual health care provider with primary practice located at 3445 S Main St , Coventry Township OH 44319-3028. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Sievert, Galen W. can be contacted via phone (330) 644-4095.

Contact Information

Primary practice address
3445 S Main St Coventry Township OH 44319-3028
Phone: (330) 644-4095
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 051036 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E7470 Ohio

Profile Details

NPI number 1104930858
LBN Legal business name Sievert, Galen W.
Credentials PCC-S, LICDC-CS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Apr 28th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104930858 NPPES
Ohio MEDICAID 0164036

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