Provider Demographics
NPI:1821265901
Name:SIEGARD, STEVEN D (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:D
Last Name:SIEGARD
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NORTHAMPTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12067
Mailing Address - Country:US
Mailing Address - Phone:518-843-7532
Mailing Address - Fax:518-843-7537
Practice Address - Street 1:8 NORTHAMPTON RD
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-3224
Practice Address - Country:US
Practice Address - Phone:518-843-7532
Practice Address - Fax:518-843-7537
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054181-1101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health