Provider Demographics
NPI:1912923954
Name:SIEGMAN, KAREN ANN (LCSWC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:SIEGMAN
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 GODDARD PKWY
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-1126
Mailing Address - Country:US
Mailing Address - Phone:410-334-6961
Mailing Address - Fax:410-334-6960
Practice Address - Street 1:29520 CANVASBACK DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7124
Practice Address - Country:US
Practice Address - Phone:410-822-5007
Practice Address - Fax:410-822-5569
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2131470OtherUNITED HEALTH CARE MAMSI
MD522156095OtherAMERICAN PSYCH SYSTEM
MDR968OtherCAREFIRST FEDERAL GROUP#
MD645243-02OtherCAREFIRST BCBS
MD731821OtherNCPPO
MD609550001Medicaid
MD609550004Medicaid
MD824085-000OtherMAGELLAN
MD0023OtherCAREFIRST FEDERAL
MDLM49EAOtherCAREFIRST BCBS GROUP#
MD609550002Medicaid
MD0023OtherCAREFIRST FEDERAL
MD731821OtherNCPPO
MDR968OtherCAREFIRST FEDERAL GROUP#
MD522156095OtherESPS TIN