Provider Demographics
NPI:1295738029
Name:SIGLER, TODD MICHAEL (PSYD, LP, NCC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:SIGLER
Suffix:
Gender:M
Credentials:PSYD, LP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 COUNTY ROAD B2 W STE 270
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2785
Mailing Address - Country:US
Mailing Address - Phone:651-481-0664
Mailing Address - Fax:612-392-0400
Practice Address - Street 1:1935 COUNTY ROAD B2 W STE 270
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2785
Practice Address - Country:US
Practice Address - Phone:651-481-0664
Practice Address - Fax:612-392-0400
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001032011101Y00000X
88344101Y00000X
MNLP4505101YM0800X, 103T00000X, 103TC1900X, 103TM1800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN701153900Medicaid
MN701153900Medicaid