Provider Demographics
NPI:1164787339
Name:SIEGEL, MARGO J (LMSW)
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:J
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 FARMINGTON RD
Mailing Address - Street 2:SUITE #108
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3348
Mailing Address - Country:US
Mailing Address - Phone:248-522-9942
Mailing Address - Fax:248-864-2540
Practice Address - Street 1:27600 FARMINGTON RD
Practice Address - Street 2:SUITE #108
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3348
Practice Address - Country:US
Practice Address - Phone:248-522-9942
Practice Address - Fax:248-864-2540
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010951941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical