Healthcare Provider Details

I. General information

NPI: 1205491032
Provider Name (Legal Business Name): DARIA SIEGEL LPCA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 CHAPEL HILL RD STE A
DURHAM NC
27707-1177
US

IV. Provider business mailing address

109 SHADOWOOD DR APT X
CHAPEL HILL NC
27514-2410
US

V. Phone/Fax

Practice location:
  • Phone: 919-246-5664
  • Fax:
Mailing address:
  • Phone: 704-724-1097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA14224
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: