Provider Demographics
NPI:1043698657
Name:SIEGEL, KIAH (LMHCA, MHP)
Entity Type:Individual
Prefix:
First Name:KIAH
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:LMHCA, MHP
Other - Prefix:
Other - First Name:KIAH
Other - Middle Name:
Other - Last Name:BRESLIN-KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHCA, MHP
Mailing Address - Street 1:3754 W INDIAN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4736
Mailing Address - Country:US
Mailing Address - Phone:509-559-3100
Mailing Address - Fax:
Practice Address - Street 1:3754 W INDIAN TRAIL RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4736
Practice Address - Country:US
Practice Address - Phone:509-328-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61018075101YM0800X
WACO60495889101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMC60780014OtherWASHINGTON STATE DEPARTMENT OF HEALTH