Healthcare Provider Details

I. General information

NPI: 1184716961
Provider Name (Legal Business Name): STEPHEN JOEL SIGELMAN LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEFENSE HEALTH AGENCY INDO-PACIFIC MARKET 374TH MED GROUP, YOKOTA AIRBASE
APO AP
96326
US

IV. Provider business mailing address

PSC 78 BOX 686
APO AP
96326-0007
US

V. Phone/Fax

Practice location:
  • Phone: 315-225-9546
  • Fax:
Mailing address:
  • Phone: 315-225-9546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25793
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: