Provider Demographics
NPI:1013485788
Name:SMULIAN-SIEGEL, DEBORAH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SMULIAN-SIEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:SMULIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BC-DMT; LMFT;CGP
Mailing Address - Street 1:26 BEACON ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3804
Mailing Address - Country:US
Mailing Address - Phone:646-546-2285
Mailing Address - Fax:
Practice Address - Street 1:26 BEACON ST APT 3E
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3804
Practice Address - Country:US
Practice Address - Phone:646-546-2285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2133961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical