MEDICARE: CATHERINE THERESE SIEGEL I

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1962205906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE THERESE SIEGEL I

Provider Business Mailing Address
First Line	:	220 SE 2ND ST APT 1906
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-4193
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 VERMONT AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-1868
Country	:	US
Telephone Number	:	816-860-0293
Fax Number	:

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

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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Directions to “ CATHERINE THERESE SIEGEL I ” Practice Location

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