Provider Demographics
NPI:1578813796
Name:SEGGELIN, ALICIA EDNA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:EDNA
Last Name:SEGGELIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54R BEMIS RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-6350
Mailing Address - Country:US
Mailing Address - Phone:978-578-0719
Mailing Address - Fax:
Practice Address - Street 1:54R BEMIS RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6350
Practice Address - Country:US
Practice Address - Phone:978-578-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health