Provider Demographics
NPI:1942255526
Name:SIGWARD PSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:SIGWARD PSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIGWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-699-1815
Mailing Address - Street 1:PO BOX 634241
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-699-1815
Mailing Address - Fax:513-699-1831
Practice Address - Street 1:4015 EXECUTIVE PARK DR
Practice Address - Street 2:STE 406
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-4017
Practice Address - Country:US
Practice Address - Phone:513-699-1815
Practice Address - Fax:513-699-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2672675Medicaid
DQ2095OtherRR MEDICARE
KY7366Medicare PIN
DQ2095OtherRR MEDICARE