Provider Demographics
NPI:1780494138
Name:SEIFERT, DEREK ALLEN
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:ALLEN
Last Name:SEIFERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19318 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9336
Mailing Address - Country:US
Mailing Address - Phone:513-236-3965
Mailing Address - Fax:
Practice Address - Street 1:8040 HOSBROOK RD STE 320
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2908
Practice Address - Country:US
Practice Address - Phone:888-830-0347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2405606-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health