MEDICARE: DR. CAROL F. SIEGEL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	LP4422	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	600R5SI	OTHER	MN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1154327211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL F. SIEGEL PH.D.

Provider Business Mailing Address
First Line	:	1516 W LAKE ST
Second Line	:	STE 214
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2554
Country	:	US
Telephone Number	:	612-825-4307
Fax Number	:	612-821-4349

Provider Business Practice Location Address
First Line	:	1516 W LAKE ST
Second Line	:	STE 214
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2554
Country	:	US
Telephone Number	:	612-825-4307
Fax Number	:	612-821-4349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1811908981 — DR. NANCY JANE HAMILTON D.D.S.
Practice Location Address:

1516 W LAKE ST , SUITE 302
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-822-1484
Practice Fax:

1326059478 — DR. PATRICK JAMES PROCHASKA D.D.S.
Practice Location Address:

1516 W LAKE ST , SUITE 302
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-822-1484
Practice Fax: 612-822-9458

1093828261 — LOWRY HILL DENTAL CLINIC PATRICK J PROCHASKA DDS ET.AL PARTNERS
Practice Location Address:

1516 W LAKE ST , SUITE 302
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-822-1484
Practice Fax: 612-822-9458

1932206539 — UPTOWN SMILE LLC
Practice Location Address:

1516 W LAKE ST , SUITE 302
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-822-4184
Practice Fax: 612-822-9458

1508932278 — BROCKMAN SCHUMACHER JR. L.P.
Practice Location Address:

1516 W LAKE ST STE 350C
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-232-0567
Practice Fax: 612-584-3915

1902951031 — MR. HERMAN TED THOMPSON LP
Practice Location Address:

1516 W LAKE ST
MINNEAPOLIS, MN
55408-2554

Practice Phone: 612-821-2099
Practice Fax: 612-821-2099

Directions to “ DR. CAROL F. SIEGEL PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.