Provider Demographics
NPI:1831594316
Name:SIEGEL, SAMANTHA (MA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4159 LOWELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211
Mailing Address - Country:US
Mailing Address - Phone:303-458-7220
Mailing Address - Fax:
Practice Address - Street 1:4159 LOWELL BLVD.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211
Practice Address - Country:US
Practice Address - Phone:303-458-7220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health