| Live Fully Trauma Therapy Llc | |
|
2200 Hamilton St Ste 325 Allentown PA 18104-6329 | |
| (484) 706-9832 | |
| Not Available |
| Full Name | Live Fully Trauma Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2200 Hamilton St Ste 325, Allentown, Pennsylvania |
| Authorized Official Name and Position | Michele Siegfried (THERAPIST) |
| Authorized Official Contact | 4847069832 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Fully Trauma Therapy Llc 2200 Hamilton St Allentown PA 18104-6337 Ph: (484) 706-9832 | Live Fully Trauma Therapy Llc 2200 Hamilton St Ste 325 Allentown PA 18104-6329 Ph: (484) 706-9832 |
| NPI Number | 1831963701 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 10/26/2024 |
| Certification Date | 10/26/2024 |
| Medicare PECOS PAC ID | 5496106726 |
|---|---|
| Medicare Enrollment ID | O20240110004324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831963701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle L Siegfried |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285125237 PECOS PAC ID: 4981013778 Enrollment ID: I20210507000094 |
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