Active NPI
Carol F. Siegel, PH.D.
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1154327211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP4422
- Practice address
- 1516 W Lake St
Ste 214
Minneapolis, MN 55408-2554 - Phone
- (612) 825-4307
- Fax
- (612) 821-4349
- NPI assigned
- Jun 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4422 | MN | Primary |
Addresses
Primary practice location
1516 W Lake St
Ste 214
Minneapolis, MN 55408-2554
Mailing address
1516 W Lake St
Ste 214
Minneapolis, MN 55408-2554
Phone (612) 825-4307
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600R5SI | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4422 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1154327211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 W LAKE ST",
"address_2": "STE 214",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082554",
"telephone_number": "612-825-4307",
"fax_number": "612-821-4349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 W LAKE ST",
"address_2": "STE 214",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554082554",
"telephone_number": "612-825-4307",
"fax_number": "612-821-4349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEGEL",
"first_name": "CAROL",
"middle_name": "F.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4422",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "600R5SI",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.