Provider Demographics
NPI:1396860789
Name:SEIGEL, ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:
Last Name:SEIGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 ANTELOPE WAY
Mailing Address - Street 2:APT 2B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5414
Mailing Address - Country:US
Mailing Address - Phone:614-842-4374
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2508
Practice Address - Country:US
Practice Address - Phone:614-842-4374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10700081041C0700X
NYR0217021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical