Provider Demographics
NPI:1881781441
Name:SIGEL, VIRGINIA GUPTILL (MSW/LICSW)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:GUPTILL
Last Name:SIGEL
Suffix:
Gender:F
Credentials:MSW/LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-2204
Mailing Address - Country:US
Mailing Address - Phone:617-969-4575
Mailing Address - Fax:
Practice Address - Street 1:93 UNION ST
Practice Address - Street 2:SUITE 303C
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-2244
Practice Address - Country:US
Practice Address - Phone:617-699-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1033951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical