Provider Demographics
NPI:1124487012
Name:SIEGEL, TAMARA ANN I (MA, LPC)
Entity type:Individual
Prefix:MISS
First Name:TAMARA
Middle Name:ANN
Last Name:SIEGEL
Suffix:I
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BIG SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416-9714
Mailing Address - Country:US
Mailing Address - Phone:973-713-7055
Mailing Address - Fax:973-209-4357
Practice Address - Street 1:58 BIG SPRING RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416-9714
Practice Address - Country:US
Practice Address - Phone:973-713-7055
Practice Address - Fax:973-209-4357
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00525400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional