Provider Demographics
NPI:1003935289
Name:JUNE SIEGEL MSW CISW PC
Entity Type:Organization
Organization Name:JUNE SIEGEL MSW CISW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-491-4840
Mailing Address - Street 1:1830 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3056
Mailing Address - Country:US
Mailing Address - Phone:480-491-4840
Mailing Address - Fax:480-491-5327
Practice Address - Street 1:1830 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 135
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3056
Practice Address - Country:US
Practice Address - Phone:480-491-4840
Practice Address - Fax:480-491-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 0821261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health