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NPI Code Detail

MEDICARE: MISS MICHELLE A SIEGEL LCSW

MEDICARE:  MISS MICHELLE A SIEGEL  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
11041C0700XClinical Social Worker214103MA

General Provider Information

NPI Number : 1598825622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MICHELLE A SIEGEL LCSW
Provider Business Mailing Address
First Line : 50 LARCH ST
Second Line :
City : BRIGHTON
State : MA
Zip : 02135-3023
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1800 COLUMBUS AVE
Second Line :
City : ROXBURY
State : MA
Zip : 02119-1042
Country : US
Telephone Number : 617-442-8800
Fax Number : 617-442-6762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ MISS MICHELLE A SIEGEL LCSW” Practice Location

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