Healthcare Provider Details

I. General information

NPI: 1801179098
Provider Name (Legal Business Name): TERRI RAE SIGLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRI RAE JOHNSON LSW

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-7917
  • Fax: 717-560-6452
Mailing address:
  • Phone: 717-560-7917
  • Fax: 717-560-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW128152
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW019335
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: