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NPI Code Detail

MEDICARE: CHRISTOPHER BLAINE SIEGNER LCSW,QMHP

MEDICARE: CHRISTOPHER BLAINE SIEGNER LCSW,QMHP
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3106H00000XMarriage & Family Therapist
41041C0700XClinical Social Worker3350OR

General Provider Information

NPI Number : 1356472328
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER BLAINE SIEGNER LCSW,QMHP
Provider Business Mailing Address
First Line : 348 W ADAMS ST
Second Line :
City : BURNS
State : OR
Zip : 97720-1710
Country : US
Telephone Number : 541-573-8376
Fax Number :
Provider Business Practice Location Address
First Line : 348 W ADAMS ST
Second Line :
City : BURNS
State : OR
Zip : 97720-1710
Country : US
Telephone Number : 541-573-8376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 08/07/2015

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