Individual provider Active NPI

Christopher Blaine Siegner, LCSW,QMHP

  • Clinical Social Worker
  • Burns, OR
National Provider Identifier
1356472328
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3350 Issued in OR
Practice address
348 W Adams St
Burns, OR 97720-1710
Phone
(541) 573-8376
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X
Clinical Social Worker 1041C0700X 3350 OR Primary

Addresses

Primary practice location

348 W Adams St
Burns, OR 97720-1710

Mailing address

348 W Adams St
Burns, OR 97720-1710
Phone (541) 573-8376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181029000605 OR Practitioner - Clinical Social Worker 7416230636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3350ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Symmetry Care, Inc. Counselor CurrentSince Aug 14, 2018 Accepting new patients
Symmetry Care, Inc. Counselor Current Accepting new patients
Symmetry Care, Inc. CurrentSince Jan 9, 2017 Accepting new patients

Locations

348 W Adams St
Burns, OR 97720
Phone (541) 573-8376

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1356472328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGNER",
        "first_name": "CHRISTOPHER",
        "middle_name": "BLAINE",
        "credential": "LCSW,QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burns, OR

Sources for this page

Verify at the official NPI Registry.