Provider Demographics
NPI:1114138435
Name:SIEGEL, JUDITH PAULA (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:PAULA
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 URBAN ST
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1322
Mailing Address - Country:US
Mailing Address - Phone:914-381-0407
Mailing Address - Fax:
Practice Address - Street 1:1625 URBAN ST
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1322
Practice Address - Country:US
Practice Address - Phone:914-381-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039835-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical