MEDICARE: MRS. MICHELE D SELIGMAN LCSW

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	1041C0700X	Clinical Social Worker	44SC00203300	NJ
2	106H00000X	Marriage & Family Therapist	37F100049900	NJ

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	:	1417045568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE D SELIGMAN LCSW

Provider Business Mailing Address
First Line	:	45 N. BROAD ST. SUITE 206
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3822
Country	:	US
Telephone Number	:	201-444-5347
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 N. BROAD ST.
Second Line	:	SUITE 406
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3822
Country	:	US
Telephone Number	:	201-444-5347
Fax Number	:

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	05/23/2012

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