Provider Demographics
NPI:1447434337
Name:SIEGAL, DONNA REBECCA (LCSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:REBECCA
Last Name:SIEGAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DEER HILL LN
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1801
Mailing Address - Country:US
Mailing Address - Phone:212-308-1181
Mailing Address - Fax:
Practice Address - Street 1:9 DEER HILL LN
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF
Practice Address - State:NY
Practice Address - Zip Code:10510-1801
Practice Address - Country:US
Practice Address - Phone:212-308-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR337301104100000X
NYR337311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker