Provider Demographics
NPI:1033540406
Name:SIEGMAN, JAMES (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SIEGMAN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29446 HEMLOCK LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4885
Mailing Address - Country:US
Mailing Address - Phone:410-334-6961
Mailing Address - Fax:410-334-6362
Practice Address - Street 1:29446 HEMLOCK LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4885
Practice Address - Country:US
Practice Address - Phone:410-822-5007
Practice Address - Fax:410-822-5569
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19045104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD742LOtherNOVITAS/MEDICARE
MD609550002Medicaid
MD346646OtherMHN/TRICARE
MDR968OtherCAREFIRST
MD522156095OtherCOMMERCIAL INSURANCE
MD259147-000OtherMAGELLAN BEHAVIORAL HEALTH
MD7840093OtherAETNA
MD517251OtherOPTUM