MEDICARE: DR. TODD MICHAEL SIGLER PSY.D., LP, NCC

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	101Y00000X	Counselor	2001032011	MO
2	101Y00000X	Counselor	88344
3	101YM0800X	Mental Health Counselor	LP4505	MN
4	103T00000X	Psychologist	LP4505	MN
5	103TC1900X	Counseling Psychologist	LP4505	MN
6	103TM1800X	Intellectual & Developmental Disabilities Psychologist	LP4505	MN
7	103TC0700X	Clinical Psychologist	LP4505	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295738029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD MICHAEL SIGLER PSY.D., LP, NCC

Provider Business Mailing Address
First Line	:	1935 COUNTY ROAD B2 W STE 270
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-2785
Country	:	US
Telephone Number	:	651-481-0664
Fax Number	:	612-392-0400

Provider Business Practice Location Address
First Line	:	1935 COUNTY ROAD B2 W STE 270
Second Line	:
City	:	ROSEVILLE
State	:	MN
Zip	:	55113-2785
Country	:	US
Telephone Number	:	651-481-0664
Fax Number	:	612-392-0400

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/02/2020

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