Galen W. Sievert, PCC-S, LICDC-CS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E7470 Issued in OH

Practice address

3445 S Main St
Coventry Township, OH 44319-3028

Phone

(330) 644-4095

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vantage Aging

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Akron, OH
  • NPI 1548222656
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1104930858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 WOODBINE AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443137632",
            "telephone_number": "330-622-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 S MAIN ST",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443193028",
            "telephone_number": "330-644-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEVERT",
        "first_name": "GALEN",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "PCC-S, LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "051036",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E7470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164036",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tierney L Shumaker
• Troy J Sidner, CT
• Charles Spahr
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• Michael George Swartout, CDCA

• Professional Counselor in Coventry Township, OH
• Providers in Coventry Township, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.