Provider Demographics
NPI:1023153756
Name:SEIGEL, ALAN (CLINICAL SOCIAL WORK)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:SEIGEL
Suffix:
Gender:M
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 DWIGHT RD STE 104
Mailing Address - Street 2:THERAPEUTIC ASSOCIATES PC
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1769
Mailing Address - Country:US
Mailing Address - Phone:413-567-5533
Mailing Address - Fax:413-567-9010
Practice Address - Street 1:3300 MAIN ST
Practice Address - Street 2:ADULT BEHAVIORAL HEALTHY BAYSTATE MEDICAL CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1002
Practice Address - Country:US
Practice Address - Phone:413-794-7035
Practice Address - Fax:413-794-7130
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1008161041C0700X
CT0024821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP20713Medicare ID - Type Unspecified