Provider Demographics
NPI:1518301142
Name:SIEGAL, GAIL (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:SIEGAL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W 15TH ST
Mailing Address - Street 2:#1021
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6838
Mailing Address - Country:US
Mailing Address - Phone:917-648-9322
Mailing Address - Fax:
Practice Address - Street 1:315 8TH AVE
Practice Address - Street 2:#7J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4809
Practice Address - Country:US
Practice Address - Phone:917-648-9322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071244-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical