Provider Demographics
NPI:1871095653
Name:SIEGEL, LAURIE ANN (LCSW)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:SIEGEL
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 1:14A MILLER ST
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-3219
Mailing Address - Country:US
Mailing Address - Phone:914-960-7727
Mailing Address - Fax:
Practice Address - Street 1:75 RIVERDALE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3645
Practice Address - Country:US
Practice Address - Phone:914-376-8278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0807321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical