Kellsie Rae Siebach, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

00961 Issued in NC

Practice address

4239 Cameron Rd
Fayetteville, NC 28306-7106

Phone

(919) 295-0364

Fax

(844) 321-8479

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cbok Solutions PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fayetteville, NC
  • NPI 1891560611
  NPD Authorized official
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  Medicare reassignment
• Banner Consulting and Counseling of North Carolina, PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1710508205

  Marriage & Family Therapist

  NPD
• Lifeline at Alphaomega

  • Professional Counselor
  • Chandler, AZ
  • NPI 1225404684
  NPD (past)

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1831683796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4239 CAMERON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283067106",
            "telephone_number": "919-295-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 CAMERON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283067106",
            "telephone_number": "919-295-0364",
            "fax_number": "844-321-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBACH",
        "first_name": "KELLSIE",
        "middle_name": "RAE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717002682",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "00961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Ann Shumard
• Joseph L Shurtleff, DDS
• Hunnain Siddiqui, PHARMD
• Stacie A Sidebotham, FNP
• Deborah Jean Sides, NP
• Kate Sifuentes
• Breanna Sigler, PHARMD
• Sigma Solutions, PLLC
• Zachary Sikder
• Jenelle Silva

• Marriage & Family Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.